Kidada A Mitchell, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

117012 Issued in TX

Practice address

3816 S Clear Creek Rd
Suite B
Killeen, TX 76549-4400

Phone

(254) 699-3933

NPI assigned

Dec 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kidada A Stokes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ir Home Health

  • Home Health Agency
  • Killeen, TX
  • NPI 1770537110
  NPD (past) Authorized official

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1972587632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10340",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765470340",
            "telephone_number": "254-699-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 S CLEAR CREEK RD",
            "address_2": "SUITE B",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494400",
            "telephone_number": "254-699-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIDADA",
        "middle_name": "A",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8T1272",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIDADA",
            "last_name": "STOKES",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danny E Mitchell
• David Henry Mitchell, PA
• Deborah Michelle Mitchell, NNP-BC
• Jeanice Amy Mitchell, MPT
• Karen-Mae Mitchell, MD
• Kimberly M Mitchell, CCC-SLP
• Ricky D Mitchell, M.D.
• Mollye Katherine Mlcak, PT, DPT
• MLMD PA
• Jonathan Dean Mock, MD

• Occupational Therapist in Killeen, TX
• Providers in Killeen, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.