Active NPI
Katy Amorelle Kent, OTR/L
- Occupational Therapist
- Bossier City, LA
National Provider Identifier
1629428073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR2705
- Practice address
- 2285 Benton Rd.
Suite C-200
Bossier City, LA 71111 - Phone
- (870) 904-3412
- NPI assigned
- Jun 16, 2016
- Last updated
- Dec 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR2705 | AR | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 301663 | LA |
Addresses
Primary practice location
2285 Benton Rd.
Suite C-200
Bossier City, LA 71111
Mailing address
2285 Benton Rd.
Suite C-200
Bossier City, LA 71111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2445243 | Medicaid | LA |
Other names 1
- Katy Correa
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTR2705 | AR | MD | Occupational Therapist |
| 301663 | LA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloom Therapy Services | Pediatrics | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1629428073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2285 BENTON RD.",
"address_2": "SUITE C-200",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "71111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2285 BENTON RD.",
"address_2": "SUITE C-200",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "71111",
"telephone_number": "870-904-3412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENT",
"first_name": "KATY",
"middle_name": "AMORELLE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-16",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR2705",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "LA",
"license": "301663",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2445243",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATY",
"last_name": "CORREA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.