Kimberly Crockett Hayes

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

928 Issued in GA

Practice address

2465 Canopy GLN
Marietta, GA 30066-1541

Phone

(770) 517-2480

Fax

(770) 592-9431

NPI assigned

Mar 5, 2008

Last updated

Mar 5, 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 2

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kool Kidz Inc

  • Pediatric Physical Therapist
  • Marietta, GA
  • NPI 1134386337

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1730359738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670207",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300660121",
            "telephone_number": "770-517-2480",
            "fax_number": "770-592-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 CANOPY GLN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300661541",
            "telephone_number": "770-517-2480",
            "fax_number": "770-592-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "KIMBERLY",
        "middle_name": "CROCKETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "928",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL LICENSE",
            "identifier": "928",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Brian Hawkins, D.D.S.,M.A.G.D.
• Christina C. Hawkridge, M.D.
• Asad Ali Hayat, M.D.
• David C. Haydon, DDS
• Angela Hayes-Boucher, DO
• Latoya Hayes, LPC
• Laura Joanna Hayes, ED.D.
• Maedot Haymete, MD
• Adrianne Hays, P.T.
• Bobbie Janeen Hayward, APRN, AGPCNP-BC

• Occupational Therapist in Marietta, GA
• Providers in Marietta, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.