Individual provider Active NPI

Kaitlyn Reaux Johnson, LOTR

  • Occupational Therapist
  • Carencro, LA
National Provider Identifier
1669997672
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
304852 Issued in LA
Practice address
204 E Saint Peter St
Carencro, LA 70520-4009
Phone
(337) 896-6686
Fax
(337) 565-6003
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 304852 LA Primary

Addresses

Primary practice location

204 E Saint Peter St
Carencro, LA 70520-4009

Mailing address

2002 Johnson St Ste 100
Jennings, LA 70546-3640
Phone (337) 824-4547

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Clinic of Carencro LLC PastSince Aug 10, 2017 Accepting new patients
Lemoine Therapy Services of Cenla Inc Occupational Therapist PastSince Aug 10, 2017 Accepting new patients

Organizations & group practices 2

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502323200000",
    "number": "1669997672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 JOHNSON ST STE 100",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463640",
            "telephone_number": "337-824-4547",
            "fax_number": "337-824-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E SAINT PETER ST",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "705204009",
            "telephone_number": "337-896-6686",
            "fax_number": "337-565-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAITLYN",
        "middle_name": "REAUX",
        "credential": "LOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2017-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "304852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carencro, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; 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.