Individual provider Active NPI

Kelly Ann Degnan, OTR/L

  • Occupational Therapist
  • Whitestone, NY
National Provider Identifier
1104525005
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
027766 Issued in NY
Practice address
15050 14TH Rd
Whitestone, NY 11357-2609
Phone
(718) 767-0071
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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 027766 NY Primary

Addresses

Primary practice location

15050 14TH Rd
Whitestone, NY 11357-2609

Mailing address

14 Winter St
Lynbrook, NY 11563-1451
Phone (917) 923-1619

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

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1104525005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WINTER ST",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115631451",
            "telephone_number": "917-923-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15050 14TH RD",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572609",
            "telephone_number": "718-767-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGNAN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "027766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.