Active NPI
Kayley Ann Johnson
- Occupational Therapist
- Windham, ME
National Provider Identifier
1811525868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3802
- Practice address
- 10 Trails End Rd
Windham, ME 04062-7307 - Phone
- (207) 233-7373
- NPI assigned
- Mar 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3802 | ME | Primary |
Addresses
Primary practice location
10 Trails End Rd
Windham, ME 04062-7307
Mailing address
37 South St
Freeport, ME 04032-1513
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3802 | ME | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Maine Pediatric Therapies, PLLC | 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.
-
- Occupational Therapist
- Gorham, ME
- NPI 1174867576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585267200000",
"number": "1811525868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 SOUTH ST",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040321513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 TRAILS END RD",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040627307",
"telephone_number": "207-233-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KAYLEY",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-27",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "3802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.