McKayla Marie Kimball
Individual provider Active NPI Occupational Therapist · Altavista, VA
NPI 1629930797 · NPPES record last updated Dec 5, 2025
Key facts
- NPI
- 1629930797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 030599 (NY)
- Practice address
- 1317 Lola Ave
Altavista, VA 24517-1352 - Phone
- (434) 369-6651
- NPI assigned
- Nov 26, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030599 | NY | MD | Physical Therapist |
| OC021220 | PA | MD | Occupational Therapist |
| 0119011228 | VA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 030599 | NY | Yes |
| Occupational Therapist | 225X00000X | OC021220 | PA | |
| Occupational Therapist | 225X00000X | 0119011228 | VA |
Addresses
Primary practice location
1317 Lola Ave
Altavista, VA 24517-1352
Mailing address
1872 State Route 30
North Blenheim, NY 12131-1604
Phone (518) 545-7455
Other providers in Altavista, VA
- Gwen Hooks
- Horizon Behavioral Health
- Jeff Dalton Inc Medicine Shoppe
- Julian Fields, DDS LTD
- Julian W. Fields D.D.S., LTD.
- Anna Legard
- Allison Maddy
- Katelyn Overstreet
- Stacey M Owen
- Palmer Chiropractic Center, Inc.
All providers in Altavista, VA · Occupational Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.