Individual provider Active NPI

Tai Gray Killian, M.S.O.T.

  • Occupational Therapist
  • Wichita Falls, TX
National Provider Identifier
1609108117
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
112959 Issued in TX
Practice address
5038 Jacksboro Hwy
#302
Wichita Falls, TX 76302-3531
Phone
(940) 781-1776
NPI assigned
Feb 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 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 112959 TX Primary

Addresses

Primary practice location

5038 Jacksboro Hwy
#302
Wichita Falls, TX 76302-3531

Mailing address

5038 Jacksboro Hwy
#302
Wichita Falls, TX 76302-3531
Phone (940) 781-1776

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
112959TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1609108117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5038 JACKSBORO HWY",
            "address_2": "#302",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763023531",
            "telephone_number": "940-781-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5038 JACKSBORO HWY",
            "address_2": "#302",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763023531",
            "telephone_number": "940-781-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "TAI",
        "middle_name": "GRAY",
        "credential": "M.S.O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.