Individual provider Active NPI

Kelley D Cutcliff

  • Occupational Therapist
  • Watkinsville, GA
National Provider Identifier
1073241741
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008570 Issued in GA
Practice address
1071 Thomas Ave
Watkinsville, GA 30677-6073
Phone
(770) 207-6390
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 OT008570 GA Primary

Addresses

Primary practice location

1071 Thomas Ave
Watkinsville, GA 30677-6073

Mailing address

1071 Thomas Ave
Watkinsville, GA 30677-6073

Other identifiers 1

IdentifierTypeStateIssuer
OT008570OtherGAGEORGIA STATE BOARD

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
OT008570GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1073241741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 THOMAS AVE",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 THOMAS AVE",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776073",
            "telephone_number": "770-207-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTCLIFF",
        "first_name": "KELLEY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA STATE BOARD",
            "identifier": "OT008570",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.