Kelly Noel Greenly, COTA
Individual provider Active NPI Occupational Therapy Assistant · Seaford, DE
NPI 1134242589 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1134242589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- U20000662 (DE)
- Practice address
- 801 Middleford Rd
Seaford, DE 19973-3636 - Phone
- (302) 628-3000
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U20000662 | DE | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | U20000662 | DE | Yes |
Addresses
Primary practice location
801 Middleford Rd
Seaford, DE 19973-3636
Mailing address
18848 Washington Street
Lincoln, DE 19960-3128
Phone (302) 422-3254
NPI Registry JSON
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134242589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18848 WASHINGTON STREET",
"city": "LINCOLN",
"state": "DE",
"postal_code": "199603128",
"telephone_number": "302-422-3254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 MIDDLEFORD RD",
"city": "SEAFORD",
"state": "DE",
"postal_code": "199733636",
"telephone_number": "302-628-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENLY",
"first_name": "KELLY",
"middle_name": "NOEL",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "DE",
"license": "U20000662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seaford, DE
- Natasha Gouty
- Edwina C Granada
- Mark John Granada
- Ashley Gray
- Amber Lynn Green
- Stefanie Greenwald
- Abha Gupta
- Halpern Eye Associates, P.a.
- Halpern Medical Services LLC
- Jacqueline Denise Hammond
All providers in Seaford, DE · Occupational Therapy Assistant in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.