Individual provider Active NPI

Brittney Leanne McKissick, OTR

  • Occupational Therapist
  • Bay Minette, AL
National Provider Identifier
1932784634
Registry record updated Mar 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4960 Issued in AL
Practice address
300 Faulkner Dr
Bay Minette, AL 36507-2771
Phone
(251) 937-9881
NPI assigned
Mar 14, 2021
Last updated
Mar 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2021

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 4960 AL Primary

Addresses

Primary practice location

300 Faulkner Dr
Bay Minette, AL 36507-2771

Mailing address

5616 Dogwood TRL
Eight Mile, AL 36613-8510
Phone (251) 721-1907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210419000410 AL Practitioner - Occupational Therapist in Private Practice 4082022769 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4960ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc CurrentSince Apr 12, 2021 Accepting new patients
Encore Rehabilitation, Inc. Occupational Therapist CurrentSince Apr 12, 2021 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Oct 1, 2021 Accepting new patients
USA Health Physician Billing Services LLC Occupational Therapist CurrentSince Oct 1, 2021 Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

Organizations & group practices 4

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": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615680000000",
    "number": "1932784634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 DOGWOOD TRL",
            "city": "EIGHT MILE",
            "state": "AL",
            "postal_code": "366138510",
            "telephone_number": "251-721-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FAULKNER DR",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365072771",
            "telephone_number": "251-937-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "BRITTNEY",
        "middle_name": "LEANNE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "4960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2021; 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.