Individual provider Active NPI

Kelci Jones, OTR/L

  • Occupational Therapist
  • Chula Vista, CA
National Provider Identifier
1114500832
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT21593 Issued in CA
Practice address
880 3Rd Ave Ste a
Chula Vista, CA 91911-1305
Phone
(619) 618-2035
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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 OT21593 CA Primary

Addresses

Primary practice location

880 3Rd Ave Ste a
Chula Vista, CA 91911-1305

Mailing address

3110 Deerflower Rd
San Diego, CA 92115-8223

Other practice location 1

3110 Deerflower Rd
San Diego, CA 92115-8223
Phone (904) 214-5852

Other identifiers 2

IdentifierTypeStateIssuer
338647OtherTHE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
OT21593OtherCACALIFORNIA BOARD OF OCCUPATIONAL THERAPY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220429001130 CA Practitioner - Occupational Therapist in Private Practice 2769879378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21593CAMDAddiction (Substance Use Disorder) Counselor
OT21593CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC Occupational Therapist CurrentSince Mar 25, 2022 Accepting new patients

Locations

9800 Glen Center Dr
San Diego, CA 92131
Phone (858) 444-8500

12515 Springhurst Dr
San Diego, CA 92128
Phone (858) 771-3694

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1114500832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 DEERFLOWER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921158223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 3RD AVE STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111305",
            "telephone_number": "619-618-2035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3110 Deerflower Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921158223",
            "country_code": "US",
            "telephone_number": "904-214-5852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELCI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT21593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY",
            "identifier": "338647",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF OCCUPATIONAL THERAPY",
            "identifier": "OT21593",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.