DAKOTA KYLIE THEOBALD OT
NPI 1730763194
Occupational Therapist in Madison Heights, MI
About Dakota Kylie Theobald Ot NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAKOTA KYLIE THEOBALD OT (NPI 1730763194) is an individual occupational therapist in Madison Heights, Michigan, licensed in Tennessee (6882) and active in the NPI registry since May 2021. She is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dakota Kylie Theobald Ot is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Dakota Theobald reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Madison Heights, MI 48071
- Reassigned Medicare billing, Michigan enrollment
- 9 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MADISON HTS, MI 48071
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dakota Theobald's NPI number?
The NPI number for Dakota Theobald is 1730763194. It was assigned to this individual provider in the NPPES registry on May 11, 2021.
Where is Dakota Theobald located?
Dakota Theobald practices at 30821 Barrington St, Madison Heights, MI 48071. The listed phone number is (248) 965-3916.
What is Dakota Theobald's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Dakota Theobald enrolled in Medicare?
Yes. Dakota Theobald is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Dakota Theobald's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dakota Theobald reassigns Medicare benefits to Healing Haven, LLC (Madison Heights, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dakota Theobald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Dakota Theobald was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.