NPIMap

Organization Active NPI

Kidbridge Therapy, LLC

  • Pediatric Occupational Therapist
  • Richmond Hill, GA
National Provider Identifier
1982133237
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT005053 Issued in GA
Legal business name
KIDBRIDGE THERAPY, LLC
Practice address
2384 Garden Hills Loop
Richmond Hill, GA 31324-6091
Phone
(912) 663-4118
NPI assigned
Jun 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Crystal Nicole Reynolds, MSOTR/LNPI 1679966998
Title
Owner/Occupational Therapist
Phone
(912) 663-4118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X OT005053 GA Primary

Addresses

Primary practice location

2384 Garden Hills Loop
Richmond Hill, GA 31324-6091

Mailing address

2384 Garden Hills Loop
Richmond Hill, GA 31324-6091
Phone (912) 663-4118

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982133237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2384 GARDEN HILLS LOOP",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313246091",
            "telephone_number": "912-663-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 GARDEN HILLS LOOP",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313246091",
            "telephone_number": "912-663-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDBRIDGE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "912-663-4118",
        "authorized_official_credential": "MSOTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.