Dakota Kylie Theobald, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6882 Issued in TN

Practice address

30821 Barrington St
Madison Heights, MI 48071-1871

Phone

(248) 965-3916

Fax

(248) 331-9919

NPI assigned

May 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Heightened Potential Company

  • Early Intervention Provider Agency
  • Kirkland, IL
  • NPI 1992187504
  NPD (past)

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1730763194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30821 BARRINGTON ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711871",
            "telephone_number": "248-965-3916",
            "fax_number": "248-331-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30821 BARRINGTON ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711871",
            "telephone_number": "248-965-3916",
            "fax_number": "248-331-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "DAKOTA",
        "middle_name": "KYLIE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "6882",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201014766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Teagardin
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• The Wellness Plan Medical Centers (The Wellness Plan-Keys Grace Clinic)
• Therapeutic Solutions, Inc.
• Thomas I King DPM PC
• Thomas J Hubbard OD PC
• Manju Joby Thomas
• Mincy Thomas

• Occupational Therapist in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.