NPIMap

Organization Active NPI

KDT, LLC

  • Home Health Agency
  • Houston, TX
National Provider Identifier
1699718239
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
010371 Issued in TX
Legal business name
KDT, LLC
Practice address
6109 Maple St
Houston, TX 77074-7449
Phone
(713) 668-6690
Fax
(713) 668-6563
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Authorized official

Name
Mrs. Diana P. Dinn, PT, MBANPI 1386791069
Title
Administrator
Phone
(713) 668-6690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 010371 TX Primary

Addresses

Primary practice location

6109 Maple St
Houston, TX 77074-7449

Mailing address

6109 Maple St
Houston, TX 77074-7449
Phone (713) 668-6690

Other identifiers 1

IdentifierTypeStateIssuer
145328401MedicaidTX

Other names 1

  • Kids Developmental Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060207000011 TX Part A Provider - Home Health Agency 6507880648 Practice locations: Houston, TX

Home health agency certification: CCN 679075

Legal name
KDT, LLC
Doing business as
KIDS DEVELOPMENTAL THRAPY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 4, 2001
Last certification
Feb 28, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
6109 Maple St
Houston, TX 77074-7449

Care Compare: Home health agency

Medicare Care Compare
Listed as
Kids Developmental TherapyCCN 679075
Ownership
Proprietary
Certified
Oct 4, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Services
Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
KDT LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6109 Maple St
Houston, TX 77074
Phone (713) 668-6690

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gabriel Dinn Individual 5% Or Greater Direct Ownership InterestChief Financial Officer Aug 1, 2024 52%
Corporate OfficerChief Financial Officer Feb 1, 2017 52%
W-2 Managing EmployeeChief Financial Officer Feb 1, 2017 52%
Operational/Managerial ControlChief Financial Officer Feb 1, 2017 52%
HSG Ventures, LLC Organization, Houston, TX Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2024 48%
Stacy Grazak Individual 5% Or Greater Indirect Ownership InterestAdministrator Aug 1, 2024 48%
Corporate OfficerAdministrator Aug 22, 2018 48%
W-2 Managing EmployeeAd; Aug 22, 2018 48%

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1699718239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6109 MAPLE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770747449",
            "telephone_number": "713-668-6690",
            "fax_number": "713-668-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 MAPLE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770747449",
            "telephone_number": "713-668-6690",
            "fax_number": "713-668-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KDT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "DINN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "713-668-6690",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145328401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Developmental Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.