Kelly Amyx, MSOT – Occupational Therapist

Key facts

NPI: 1023057650
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: 2969 (TN)
Practice address: 121 Village Dr
Suite 103
Portland, TN 37148-1418
Phone: (615) 323-7575
Fax: (615) 323-0677
NPI assigned: Jun 6, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Star Physical Therapy LP Rehabilitation Clinic/Center · Bolivar, TN · NPI 1417404351

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
2969	TN	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Star Physical Therapy LP		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	2969	TN	Yes

Addresses

Primary practice location

121 Village Dr
Suite 103
Portland, TN 37148-1418

Mailing address

PO Box 681478
Franklin, TN 37068-1478
Phone (866) 800-9147

Other identifiers

Identifier	Type	State	Issuer
4220815	Other	TN	BCBS OF TENNESSEE

Other providers in Portland, TN

All providers in Portland, TN · Occupational Therapist in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.