Healthcare Provider Details

I. General information

NPI: 1780553438
Provider Name (Legal Business Name): KIRAN MANISHKUMAR PATEL OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 REDBRIDGE LN
APEX NC
27502-2495
US

IV. Provider business mailing address

112 STEPPE WAY
GARNER NC
27529-7847
US

V. Phone/Fax

Practice location:
  • Phone: 919-925-4922
  • Fax: 919-925-4923
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18128
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: