Individual provider Active NPI

Kylie Waterman

  • Occupational Therapist
  • Severna Park, MD
National Provider Identifier
1841886835
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
820 Ritchie Hwy Ste 100
Severna Park, MD 21146-4111
Phone
(443) 481-1140
NPI assigned
Dec 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 Primary

Addresses

Primary practice location

820 Ritchie Hwy Ste 100
Severna Park, MD 21146-4111

Mailing address

2001 Medical Pkwy
Annapolis, MD 21401-3773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210126002469 MD Practitioner - Occupational Therapist in Private Practice 4880008283 Reassigns benefits to 3 organizations
I20210126002722 DC Practitioner - Occupational Therapist in Private Practice 4880008283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC CurrentSince Jan 4, 2021 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 1, 2022 Accepting new patients
LHMG Physical Therapy, LLC Occupational Therapist Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
LHMG Physical Therapy, LLC Occupational Therapist CurrentSince Jan 4, 2021 Accepting new patients
LHMG Physical Therapy, LLC CurrentSince Jan 4, 2021 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 1, 2022 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jan 11, 2021 Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2001 Medical Pkwy
Ofc
Annapolis, MD 21401
Phone (443) 481-1091

161 Jennifer Rd
Ste A
Annapolis, MD 21401

201 Defense Hwy
Ste 150
Annapolis, MD 21401

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401
Phone (410) 295-8900

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

1630 Main St
Ste 101
Chester, MD 21619
Phone (410) 604-6560

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

820 Ritchie Hwy
Ste 100
Severna Park, MD 21146
Phone (410) 544-6813

7611 Crain Hwy
#C170
Upper Marlboro, MD 20772

7611 Crain Hwy
Ste C170
Upper Marlboro, MD 20772

Organizations & group practices 10

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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1841886835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 RITCHIE HWY STE 100",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464111",
            "telephone_number": "443-481-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "KYLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.