Active NPI
Kelsey Tillett, OT
- Pediatric Occupational Therapist
- Paris, TX
National Provider Identifier
1043778327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 118715
- Practice address
- 3166 Clarksville St
Paris, TX 75460-8015 - Phone
- (903) 784-7702
- Fax
- (903) 784-7703
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 118715 | TX | Primary |
Addresses
Primary practice location
3166 Clarksville St
Paris, TX 75460-8015
Mailing address
3166 Clarksville St
Paris, TX 75460-8015
Phone (903) 784-7702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118715 | Other | TX | TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 118715 | TX | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1043778327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3166 CLARKSVILLE ST",
"city": "PARIS",
"state": "TX",
"postal_code": "754608015",
"telephone_number": "903-784-7702",
"fax_number": "903-784-7703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3166 CLARKSVILLE ST",
"city": "PARIS",
"state": "TX",
"postal_code": "754608015",
"telephone_number": "903-784-7702",
"fax_number": "903-784-7703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLETT",
"first_name": "KELSEY",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "118715",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS",
"identifier": "118715",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paris, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.