Individual provider Active NPI

Kassidy Halinski

  • Pediatric Occupational Therapist
  • Fishers, IN
National Provider Identifier
1790591352
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
31008557A Issued in IN
Practice address
10294 E 96TH St
Fishers, IN 46037-9497
Phone
(317) 288-7572
NPI assigned
Dec 9, 2024
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 31008557A IN Primary

Addresses

Primary practice location

10294 E 96TH St
Fishers, IN 46037-9497

Mailing address

13015 E Elster Way
Fishers, IN 46037-6313

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
31008557AINMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Innovative Developmental Services, Inc. CurrentSince Dec 15, 2024 Accepting new patients

Locations

10294 E 96th St
Fishers, IN 46037
Phone (317) 288-7572

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1790591352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13015 E ELSTER WAY",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460376313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10294 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379497",
            "telephone_number": "317-288-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALINSKI",
        "first_name": "KASSIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31008557A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.