Active NPI
Kellie Christiansen, OTR/L
- Occupational Therapist
- Lewiston, NY
National Provider Identifier
1053915744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 025262
- Practice address
- 5285 Lewiston Rd
Lewiston, NY 14092-1942 - Phone
- (716) 298-2900
- NPI assigned
- Nov 24, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 025262 | NY | Primary |
Addresses
Primary practice location
5285 Lewiston Rd
Lewiston, NY 14092-1942
Mailing address
2360 New Jerusalem Rd
Eden, NY 14057-9587
Phone (716) 263-4421
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 |
|---|---|---|---|
| 025262 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1053915744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2360 NEW JERUSALEM RD",
"city": "EDEN",
"state": "NY",
"postal_code": "140579587",
"telephone_number": "716-263-4421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5285 LEWISTON RD",
"city": "LEWISTON",
"state": "NY",
"postal_code": "140921942",
"telephone_number": "716-298-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANSEN",
"first_name": "KELLIE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-24",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "025262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lewiston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.