Individual provider Active NPI

Kelsey Marie Forrestal, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Newark, OH
National Provider Identifier
1023433026
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013097 Issued in OH
Practice address
11177 Lambs LN
Newark, OH 43055-9779
Phone
(740) 763-0408
Fax
(740) 763-0408
NPI assigned
Feb 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 013097 OH Primary

Addresses

Primary practice location

11177 Lambs LN
Newark, OH 43055-9779

Mailing address

11177 Lambs LN
Newark, OH 43055-9779
Phone (740) 763-0408

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
013097OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Rehabilitation Services, Inc Occupational Therapist Past Accepting new patients
Rehabilitative Associates Inc Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1023433026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11177 LAMBS LN",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559779",
            "telephone_number": "740-763-0408",
            "fax_number": "740-763-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11177 LAMBS LN",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559779",
            "telephone_number": "740-763-0408",
            "fax_number": "740-763-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTAL",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "013097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.