KATHLEEN TISDALE OTR/L
NPI 1902294135
Occupational Therapist in Independence, MO

Active since December 22, 2014
810 E WALNUT ST, INDEPENDENCE, MO 64050(816) 461-9600 Get Directions Write a Review

NPPES record last updated: December 22, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kathleen Tisdale Otr/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN TISDALE OTR/L (NPI 1902294135) is an individual occupational therapist in Independence, Missouri, licensed in Missouri (2013023645) and active in the NPI registry since December 2014.

NPPES Registry Identity

NPI1902294135
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameKATHLEEN TISDALECredential: OTR/L
Location Address810 E WALNUT STIndependence, MO 64050-4025
Mailing Address810 E Walnut StIndependence, MO 64050-4025 · (816) 461-9600
Sole ProprietorYes
Enumeration DateDecember 22, 2014
✔ NPI 1902294135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in MO · 2013023645
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
810 E WALNUT ST, Independence, MO 64050

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen Tisdale Otr/l is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kathleen Tisdale reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapist
2100 S SWOPE DR
Independence, MO 64057
  • Reassigned Medicare billing, Missouri enrollment
  • 4 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 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
810 E WALNUT ST
INDEPENDENCE, MO 64050
Specialist
810 E WALNUT ST
INDEPENDENCE, MO 64050
Physical Therapy Assistant
810 E WALNUT ST
INDEPENDENCE, MO 64050
Occupational Therapy Assistant
810 E WALNUT ST
INDEPENDENCE, MO 64050
Student in an Organized Health Care Education/Training Program
810 E WALNUT ST
INDEPENDENCE, MO 64050
Skilled Nursing Facility
810 E WALNUT ST
INDEPENDENCE, MO 64050
Nurse Practitioner (Gerontology)
810 E WALNUT ST
INDEPENDENCE, MO 64050
Occupational Therapy Assistant
810 E WALNUT ST
INDEPENDENCE, MO 64050

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 Kathleen Tisdale's NPI number?

The NPI number for Kathleen Tisdale is 1902294135. It was assigned to this individual provider in the NPPES registry on December 22, 2014.

Where is Kathleen Tisdale located?

Kathleen Tisdale practices at 810 E Walnut St, Independence, MO 64050. The listed phone number is (816) 461-9600.

What is Kathleen Tisdale's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Kathleen Tisdale enrolled in Medicare?

Yes. Kathleen Tisdale is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kathleen Tisdale's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Tisdale reassigns Medicare benefits to Healthpro Heritage Rehab & Fitness, LLC (Independence, MO). 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 Kathleen Tisdale'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 Kathleen Tisdale was last updated on December 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.