Kylie Macha, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

122771 Issued in TX

Practice address

1905 Leary LN
Victoria, TX 77901-2899

Phone

(361) 573-0731

Fax

(361) 573-1594

NPI assigned

Oct 18, 2022

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 identifiers 1

Other names 1

• Kylie Hicks 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

Locations

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.

• Region III Education Service Center

  • Early Intervention Provider Agency
  • Victoria, TX
  • NPI 1003981572

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1669198933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 LEARY LN",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012899",
            "telephone_number": "361-573-0731",
            "fax_number": "361-573-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 LEARY LN",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012899",
            "telephone_number": "361-573-0731",
            "fax_number": "361-573-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHA",
        "first_name": "KYLIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "122771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017427801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abolom@esc3.net",
            "affiliation": "Y",
            "affiliationName": "Region III Education Service Center",
            "address_1": "1905 Leary Ln",
            "city": "Victoria",
            "state": "TX",
            "country_code": "US",
            "postal_code": "779012899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "HICKS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Victoria, TX
• Providers in Victoria, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.