Kassidy Lien Ha, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

10999463-4201 Issued in UT

Practice address

12453 S 265 W Ste B
Draper, UT 84020-5420

Phone

(801) 443-7775

Fax

(801) 447-0107

NPI assigned

Nov 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Legendary Pediatric Therapy

  • Occupational Therapist
  • Draper, UT
  • NPI 1568869899
  NPD (past)

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1770052250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 S PARK AVE UNIT 363",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840653415",
            "telephone_number": "801-443-7775",
            "fax_number": "801-447-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12453 S 265 W STE B",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205420",
            "telephone_number": "801-443-7775",
            "fax_number": "801-447-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "KASSIDY",
        "middle_name": "LIEN",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "10999463-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Gutierrez
• Morgan Gutke
• David A. Gutzman, DDS
• Donald W Guymon
• Cindy A Guzman, PT, DPT
• Jerika Hackleman
• Madison Haddock
• Eliana Hadley
• Madelyn Hadley
• Derek Levoy Haight

• Occupational Therapist in Draper, UT
• Providers in Draper, UT by specialty
• Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.