Bailey E Kudrna, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

216225 Issued in TX

Practice address

12031 Shady Creek Dr
Whitney, TX 76692-5668

Phone

(573) 823-7694

NPI assigned

Jul 12, 2021

Last updated

Jul 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bailey Gorrell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• LP Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Hillsboro, TX
  • NPI 1861964231
  NPD

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1669044483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12031 SHADY CREEK DR",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766925668",
            "telephone_number": "573-823-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12031 SHADY CREEK DR",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766925668",
            "telephone_number": "573-823-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDRNA",
        "first_name": "BAILEY",
        "middle_name": "E",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "b.kudrna@cofk.com",
            "affiliation": "Y",
            "endpointDescription": "b.kudrna@cofk.com",
            "affiliationName": "Care Options For Kids",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12031 Shady Creek Dr",
            "city": "Whitney",
            "state": "TX",
            "country_code": "US",
            "postal_code": "766925668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BAILEY",
            "last_name": "GORRELL",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Princess Johnson
• Ayesha Siddiqua Khan, D.D.S.
• Lake Whitney Home Health Services
• Lake Whitney Operations, LLC (Paradigm Home Health)
• Lake Whitney Physical Therapy PC
• Lake Whitney Physicians Clinic LLC
• Lakeside Physicians Management LLC

• Occupational Therapy Assistant in Whitney, TX
• Providers in Whitney, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.

Verify at the official NPI Registry.