Active NPI
Kyla Elizabeth Evans, OT
- Occupational Therapist
- East Syracuse, NY
National Provider Identifier
1679034045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 022574
- Practice address
- 303 Roby Ave
East Syracuse, NY 13057-1800 - Phone
- (315) 434-3800
- NPI assigned
- Mar 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 022574 | NY | Primary |
Addresses
Primary practice location
303 Roby Ave
East Syracuse, NY 13057-1800
Mailing address
9046 Delphi Falls Rd Unit B
New Woodstock, NY 13122-9610
Phone (518) 649-2440
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022574 | NY | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1679034045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9046 DELPHI FALLS RD UNIT B",
"city": "NEW WOODSTOCK",
"state": "NY",
"postal_code": "131229610",
"telephone_number": "518-649-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 ROBY AVE",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130571800",
"telephone_number": "315-434-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "KYLA",
"middle_name": "ELIZABETH",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-28",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "022574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.