Individual provider Active NPI

Kathy R Pitts, OT

  • Occupational Therapist
  • Panama City, FL
National Provider Identifier
1720114523
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3288 Issued in FL
Practice address
3210 Jenks Ave
Panama City, FL 32405-4224
Phone
(850) 763-0603
Fax
(850) 769-5914
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3288 FL Primary
Occupational Therapist 225X00000X 303644 LA

Addresses

Primary practice location

3210 Jenks Ave
Panama City, FL 32405-4224

Mailing address

3210 Jenks Ave
Panama City, FL 32405-4224
Phone (850) 763-0603

Other practice location 1

13405 Panama City Beach Pkwy Ste A
Panama City, FL 32407-2885
Phone (850) 236-7497

Other identifiers 1

IdentifierTypeStateIssuer
593372143OtherFLTHERAPY ONE REHABILITATION CENTER

Other names 1

  • Kathy Fears Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160823000286 FL Practitioner - Occupational Therapist in Private Practice 3274828827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy One Rehabilitation Center IncGroup PAC ID 7113131475, 10 clinicians

Practice addresses (Care Compare)

3210 Jenks Ave
Panama City, FL 32405-4224
Phone (850) 763-0603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3288FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy One Rehabilitation Center, Inc. CurrentSince Jan 17, 2022 Accepting new patients

Locations

3210 Jenks Ave
Panama City, FL 32405
Phone (850) 763-0603

13405 Panama City Beach Pkwy
Ste A
Panama City Beach, FL 32407
Phone (850) 236-7497

Organizations & group practices 1

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1720114523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054224",
            "telephone_number": "850-763-0603",
            "fax_number": "850-769-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054224",
            "telephone_number": "850-763-0603",
            "fax_number": "850-769-5914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13405 Panama City Beach Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324072885",
            "country_code": "US",
            "telephone_number": "850-236-7497",
            "fax_number": "850-236-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITTS",
        "first_name": "KATHY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT3288",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "303644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPY ONE REHABILITATION CENTER",
            "identifier": "593372143",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "FEARS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.