Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristie Nickerson, MSOTR/L

Individual provider Pediatric Occupational Therapist · NPI 1851773071

Kristie Nickerson, MSOTR/L is an Occupational Therapist in Private Practice in Orangeburg, South Carolina. Qualified in 2012, 14 years ago. Practices with Southern Lakes Therapy LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Maine and South Carolina.

Years since qualifying
14
Licensed in
ME, SC
In the registry since
2015
Specialties on file
2

Practice location Address checks out

119 Ofc Park DR
Orangeburg, SC 29118-2407
Phone: (803) 536-5509
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 4040 (SC)
Pediatric Occupational Therapist Taxonomy 225XP0200X · Licence OT 3011 (ME)

Record details

NPI number1851773071
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSOTR/L
Sole proprietorNo
NPI enumeratedJune 24, 2015
Last updated in NPPESDecember 13, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Southern Lakes Therapy Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount