Kel Z Gaskin Prock, MSR, OTR L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2713 Issued in SC

Practice address

3603 Kingsley Dr
Myrtle Beach, SC 29588-7713

Phone

(843) 424-5450

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kelly Elizabeth Prock Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1003034331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 KINGSLEY DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887713",
            "telephone_number": "843-424-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3603 KINGSLEY DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887713",
            "telephone_number": "843-424-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCK",
        "first_name": "KEL Z",
        "middle_name": "GASKIN",
        "credential": "MSR, OTR L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "2713",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "PROCK",
            "middle_name": "ELIZABETH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gregory Deems Prieston, DDS
• Jennifer L Pringle, LCMHC LCAS LPC CMHC
• Sarah Prinzi, M.D.
• PRN Healthcare Staffing, LC
• Proaxis Therapy SC, LLC
• Edward L Proctor Jr., MD
• Professional Counseling Associates, Inc.
• Monika C Profige
• Progressive Physical Therapy, PA
• Danielle Marie Prol, M.S.

• Occupational Therapist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.