Kidzone OT LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT3009 Issued in SC

Legal business name

KIDZONE OT LLC

Practice address

519 Flycatcher Dr
Goose Creek, SC 29445-7341

Phone

(843) 729-2902

Fax

(843) 628-3560

NPI assigned

Apr 27, 2017

Organization subpart

No

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

Authorized official

Name

Jennifer Jones, OTR/L

Title

Occupational Therapist

Phone

(843) 729-2902

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1912432956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 FLYCATCHER DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457341",
            "telephone_number": "843-729-2902",
            "fax_number": "843-628-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 FLYCATCHER DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457341",
            "telephone_number": "843-729-2902",
            "fax_number": "843-628-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZONE OT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "843-729-2902",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "OT3009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH1570",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Bryan Flynn DMD PA
• Carolyn S Kelly
• Andrea Lynn Kennedy, MS, OTR/L
• Debra Liana Kerness, LISW-CP
• Kidd Chiropractic Center PA
• Karli Marie Kilby, MS, LCPC
• Karen L King, OD
• Rachel L. King, PA
• Jill Adrianne Kirar, D.C.
• Vance Christian Kirar, D.C.

• Pediatric Occupational Therapist in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Pediatric Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.