Kids Lead, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

KIDS LEAD, LLC

Practice address

5619 NW 86TH St
Johnston, IA 50131-1819

Phone

(515) 218-9160

NPI assigned

Dec 11, 2023

Last updated

Dec 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Davis Carmack, MS, OTD, OTR/LNPI 1417564428

Title

Chief Executive Officer

Phone

(630) 800-6083

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Davis Joelle Carmack, OTR/L

  • Occupational Therapist
  • Johnston, IA
  • NPI 1417564428
  NPD Authorized official
• Hannah Cheryl Cole

  • Pediatric Occupational Therapist
  • Clive, IA
  • NPI 1558252320

  Pediatrics

  NPD (past)
• Macy Kae Ticknor, OTD, OTR/L

  • Occupational Therapist
  • Atlantic, IA
  • NPI 1447074984
  NPD (past)

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1770350795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 37TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123306",
            "telephone_number": "630-800-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5619 NW 86TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311819",
            "telephone_number": "515-218-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS LEAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "CARMACK",
        "authorized_official_first_name": "DAVIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "630-800-6083",
        "authorized_official_credential": "MS, OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Keller
• Thomas Bebell Kelly, PHARM.D.
• Andra R Kennedy, PA
• Lauren Elizabeth Kern
• Kiddos ABA Iowa LLC
• Katherine Kline
• Fredrick T Klingbeil, MD
• Haley Lynn Kloberdanz, ARNP, PMHNP-BC
• Joshua Erich Klunker
• Darci Kobolt

• Pediatric Occupational Therapist in Johnston, IA
• Providers in Johnston, IA by specialty
• Pediatric Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.