Individual provider Active NPI

Kayla Marie Daugherty, OTR/L

  • Occupational Therapist
  • Charlotte Hall, MD
National Provider Identifier
1780161471
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
08510 Issued in MD
Practice address
29770 Three Notch Road
Suite 201
Charlotte Hall, MD 20622
Phone
(301) 290-0800
Fax
(301) 290-1313
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 08510 MD Primary

Addresses

Primary practice location

29770 Three Notch Road
Suite 201
Charlotte Hall, MD 20622

Mailing address

10535 Welch Family Farm Place
Charlotte Hall, MD 20622
Phone (301) 290-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08510MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coordinated Movements Inc Occupational Therapist Past Accepting new patients

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": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1780161471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 WELCH FAMILY FARM PLACE",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "20622",
            "telephone_number": "301-290-0800",
            "fax_number": "301-290-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29770 THREE NOTCH ROAD",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "20622",
            "telephone_number": "301-290-0800",
            "fax_number": "301-290-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "08510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Hall, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.