Kelley Pacillo, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3961 Issued in AL

Practice address

1412 N Brindlee Mountain Pkwy
Arab, AL 35016-5431

Phone

(256) 931-2013

Fax

(256) 931-2014

NPI assigned

Mar 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kelley Bernard Former name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magnolia Neuro Rehab, LLCGroup PAC ID 2769855386, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Magnolia Neuro Rehab, LLC

  • Occupational Therapist
  • Huntsville, AL
  • NPI 1194441147
  Medicare reassignment Care Compare group NPD Authorized official
• Encore Rehabiliation Inc

  • Physical Therapy Clinic/Center
  • Moulton, AL
  • NPI 1700912052
  NPD (past)
• Encore Rehabiliation Inc

  • Physical Therapy Clinic/Center
  • Decatur, AL
  • NPI 1841325891
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Theodore, AL
  • NPI 1043346380
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Muscle Shoals, AL
  • NPI 1063548345
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Birmingham, AL
  • NPI 1063881464
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Gulf Shores, AL
  • NPI 1073648036
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Somerville, AL
  • NPI 1174997514
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Orange Beach, AL
  • NPI 1316073679
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • McIntosh, AL
  • NPI 1316113087
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Russellville, AL
  • NPI 1356477624
  NPD (past)
• Encore Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Valley, AL
  • NPI 1396871679
  NPD (past)

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1013309780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 300",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-340-9708",
            "fax_number": "256-340-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 N BRINDLEE MOUNTAIN PKWY",
            "city": "ARAB",
            "state": "AL",
            "postal_code": "350165431",
            "telephone_number": "256-931-2013",
            "fax_number": "256-931-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACILLO",
        "first_name": "KELLEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1003819608",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529917620",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "BERNARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• New Directions Counseling, LLC
• Makayla Nixon, DMD
• North Alabama Smiles, PC
• Brad David Nunley, IDMT
• Occupational Therapy Services, Inc.
• Parkway Pharmacy South LLC
• Parkway Pharmacy South, LLC
• Parrish Inc
• Playwell Physical Therapy LLC
• Rhonda Lewis Poling, LPC

• Occupational Therapist in Arab, AL
• Providers in Arab, AL by specialty
• Occupational Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.