Individual provider Active NPI

Kellie Christiansen, OTR/L

  • Occupational Therapist
  • Lewiston, NY
National Provider Identifier
1053915744
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025262 Issued in NY
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

Updated by the provider on Dec 9, 2020

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 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

LicenseStateTypeSpecialty
025262NYMDSpeech-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.

Verify at the official NPI Registry.