NPIMap

Individual provider Active NPI

Kaitlyn Jean Rogers, OTR/L

  • Occupational Therapist
  • Winston Salem, NC
National Provider Identifier
1659904068
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
14626 Issued in NC
Practice address
1903 S Hawthorne Rd
Winston Salem, NC 27103-3916
Phone
(336) 718-6700
NPI assigned
Feb 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 0119-008485 VA
Occupational Therapist 225X00000X 14626 NC Primary

Addresses

Primary practice location

1903 S Hawthorne Rd
Winston Salem, NC 27103-3916

Mailing address

PO Box 601791
Charlotte, NC 28260-1791

Other practice location 1

107 N Franklin St
Christiansburg, VA 24073-2992
Phone (540) 251-3423

Other practice location 2

2400 Lee Hwy N
Pulaski, VA 24301-2326
Phone (540) 994-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200707002341 VA Practitioner - Occupational Therapist in Private Practice 5991128126 Reassigns benefits to 1 organization
I20220503000705 NC Practitioner - Occupational Therapist in Private Practice 5991128126 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119-008485VAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince May 29, 2020 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince May 29, 2020 Accepting new patients
Broad River Rehabilitation Occupational Therapist CurrentSince Jan 16, 2026 Accepting new patients

Locations

1 Pond St
Arden, NC 28704
Phone 82877452220027

1000 Ridge Crest Ln
Mount Airy, NC 27030
Phone (336) 515-6013

915 W Cooksey Dr
Thomasville, NC 27360
Phone (336) 313-0224

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

1009 Old Country Club Rd NW
Roanoke, VA 24017
Phone (540) 344-6248

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1659904068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033916",
            "telephone_number": "336-718-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 N Franklin St",
            "address_purpose": "LOCATION",
            "city": "Christiansburg",
            "state": "VA",
            "postal_code": "240732992",
            "country_code": "US",
            "telephone_number": "540-251-3423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Lee Hwy N",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "VA",
            "postal_code": "243012326",
            "country_code": "US",
            "telephone_number": "540-994-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KAITLYN",
        "middle_name": "JEAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "VA",
            "license": "0119-008485",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.