Individual provider Active NPI

Kyle O Hotard

  • Occupational Therapist
  • Raceland, LA
National Provider Identifier
1598705162
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
Z11731 Issued in LA
Practice address
115 Johnny Dufrene Dr
Raceland, LA 70394-2611
Phone
(985) 532-9662
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Z11731 LA Primary

Addresses

Primary practice location

115 Johnny Dufrene Dr
Raceland, LA 70394-2611

Mailing address

310 N Moss Dr
Houma, LA 70360-3955
Phone (985) 804-3194

Other identifiers 1

IdentifierTypeStateIssuer
1820261MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Z11731LAMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1598705162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N MOSS DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603955",
            "telephone_number": "985-804-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 JOHNNY DUFRENE DR",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942611",
            "telephone_number": "985-532-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTARD",
        "first_name": "KYLE",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "Z11731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1820261",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raceland, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.