Kenna Joan Ault, MOT, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

00375 Issued in MO

Practice address

63095 E 293 Rd
Grove, OK 74344-6013

Phone

(918) 787-6564

NPI assigned

Jan 22, 2007

Last updated

Jun 9, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kenna Joan Kinkade Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1700930203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63095 E 293 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743446013",
            "telephone_number": "918-787-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63095 E 293 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743446013",
            "telephone_number": "918-787-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULT",
        "first_name": "KENNA",
        "middle_name": "JOAN",
        "credential": "MOT, OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "00375",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-0119",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNA",
            "last_name": "KINKADE",
            "middle_name": "JOAN",
            "credential": "MOT, OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Occupational Therapist in Grove, OK
• Providers in Grove, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.