Active NPI
Kelly Anne Fonville, MS OTR IL
- Pediatric Occupational Therapist
- Conover, NC
National Provider Identifier
1063484889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 5956
- Practice address
- 3301 Overbrook Dr
Conover, NC 28613-8227 - Phone
- (828) 256-9488
- NPI assigned
- Feb 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 5956 | NC | Primary |
Addresses
Primary practice location
3301 Overbrook Dr
Conover, NC 28613-8227
Mailing address
3301 Overbrook Dr
Conover, NC 28613-8227
Phone (828) 256-9488
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 185536 | Other | NC | MEDCOST |
| 141MY | Other | NC | BCBS |
| 7301880 | Medicaid | NC |
Other names 1
- Ms. Kelly Anne Napier
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5956 | NC | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1063484889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 OVERBROOK DR",
"city": "CONOVER",
"state": "NC",
"postal_code": "286138227",
"telephone_number": "828-256-9488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 OVERBROOK DR",
"city": "CONOVER",
"state": "NC",
"postal_code": "286138227",
"telephone_number": "828-256-9488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONVILLE",
"first_name": "KELLY",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "MS OTR IL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-06",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NC",
"license": "5956",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "185536",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "141MY",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7301880",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "NAPIER",
"middle_name": "ANNE",
"prefix": "MS.",
"credential": "MS OTR IL",
"code": "1",
"type": "Former Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.