Individual provider Active NPI

Kayla Rae Kilcrease, OTD

  • Occupational Therapist
  • Livingston, TX
National Provider Identifier
1790400331
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
123075 Issued in TX
Practice address
440 US-59 Loop S
#104
Livingston, TX 77351
Phone
(936) 328-8148
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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 123075 TX Primary

Addresses

Primary practice location

440 US-59 Loop S
#104
Livingston, TX 77351

Mailing address

1017 NE County Road 3020
Kerens, TX 75144-5019
Phone (903) 467-2351

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108002134 TX Practitioner - Occupational Therapist in Private Practice 3779017066 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Riggs Speech Therapy Services LLC Occupational Therapist CurrentSince Oct 28, 2024 Accepting new patients

Locations

11133 Interstate 45 S
Conroe, TX 77302
Phone (936) 494-0570

11133 Interstate 45 S
Ste 190
Conroe, TX 77302
Phone (936) 494-0570

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": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1790400331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 NE COUNTY ROAD 3020",
            "city": "KERENS",
            "state": "TX",
            "postal_code": "751445019",
            "telephone_number": "903-467-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 US-59 LOOP S",
            "address_2": "#104",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "77351",
            "telephone_number": "936-328-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILCREASE",
        "first_name": "KAYLA",
        "middle_name": "RAE",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "123075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.