Kyosha Greene

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT16247 Issued in FL

Practice address

3624 Country LN
Lakeland, FL 33810-0238

Phone

(863) 934-6684

NPI assigned

Nov 30, 2016

Sex

Female

Sole proprietor

Yes

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

• Kyosha Howard Former name

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 and National Provider Directory roles.

• Greenehouse OT LLC

  • Occupational Therapist
  • Orlando, FL
  • NPI 1154152056
  NPD Authorized official

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1689117228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 COUNTRY LN",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338100238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 COUNTRY LN",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338100238",
            "telephone_number": "863-934-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KYOSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109618100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYOSHA",
            "last_name": "HOWARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Shepherd Green
• Suprina Michelle Green
• Grace Elizabeth Greene, DO
• Graham Foley Greene, MD
• Janice Greene, OTR/L
• Kerry-Ann Greensword
• Elise Greer, CRNA
• Gregory L. Nedurian, M.D., P.a.
• Denise Minette Gregory, LMT
• Dorothy M Gregory, APRN

• Occupational Therapist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.