Provider Demographics
NPI:1528037389
Name:THORPE, HAYLEY D (OTR)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:D
Last Name:THORPE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5429 OLD SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ALVATON
Mailing Address - State:KY
Mailing Address - Zip Code:42122-9759
Mailing Address - Country:US
Mailing Address - Phone:270-535-8550
Mailing Address - Fax:
Practice Address - Street 1:1048 ASHLEY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-2449
Practice Address - Country:US
Practice Address - Phone:270-904-6567
Practice Address - Fax:270-904-6570
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2566225X00000X
KY132712225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000375312OtherANTHEM BC/BS
KY88000591Medicaid
KY1218944OtherCHA HEALTH
KY0993503Medicare ID - Type UnspecifiedPART B INDIVIDUAL
KYP00290404Medicare ID - Type UnspecifiedRAILROAD PART B