Active NPI
Renee Michelly Kelly, OTR
- Pediatric Occupational Therapist
- Spring, TX
National Provider Identifier
1134486285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- Practice address
- 2109 Sawdust Rd
Apt. 5101
Spring, TX 77380-1733 - Phone
- (713) 376-0164
- NPI assigned
- Apr 13, 2012
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
2109 Sawdust Rd
Apt. 5101
Spring, TX 77380-1733
Mailing address
2109 Sawdust Rd
Apt. 5101
Spring, TX 77380-1733
Phone (713) 376-0164
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cobblestone Pathways, LLC | Pediatrics | Past | Accepting new patients |
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": "1334275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334275200000",
"number": "1134486285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2109 SAWDUST RD",
"address_2": "APT. 5101",
"city": "SPRING",
"state": "TX",
"postal_code": "773801733",
"telephone_number": "713-376-0164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 SAWDUST RD",
"address_2": "APT. 5101",
"city": "SPRING",
"state": "TX",
"postal_code": "773801733",
"telephone_number": "713-376-0164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "RENEE",
"middle_name": "MICHELLY",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-13",
"last_updated": "2012-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.