Individual provider Active NPI

Kaitlyn Elizabeth Wright, OTR/L

  • Occupational Therapist
  • Anderson, SC
National Provider Identifier
1790208320
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT17963 Issued in FL
Practice address
2005 E Greenville St Ste 119
Anderson, SC 29621-1575
Phone
(864) 233-5128
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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 OT17963 FL Primary

Addresses

Primary practice location

2005 E Greenville St Ste 119
Anderson, SC 29621-1575

Mailing address

2162 Serpentine Cir S
Saint Petersburg, FL 33712-6008
Phone (813) 317-0613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171009000390 SC Practitioner - Occupational Therapist in Private Practice 0042585655 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT17963FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services of South Carolina, LLC Occupational Therapist CurrentSince Sep 24, 2018 Accepting new patients
Elite Integrated Therapy Centers, LLC CurrentSince Sep 5, 2017 Accepting new patients

Locations

2005 E Greenville St
Ste 119
Anderson, SC 29621
Phone (864) 512-7023

1011 Grove Rd
Ste 2A
Greenville, SC 29605
Phone (864) 232-4577

Organizations & group practices 2

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1790208320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2162 SERPENTINE CIR S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337126008",
            "telephone_number": "813-317-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 E GREENVILLE ST STE 119",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211575",
            "telephone_number": "864-233-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KAITLYN",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.