Kellye Ann Wentworth, OT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

TO2446 Issued in ME

Practice address

141 Leighton St
Pittsfield, ME 04967-3718

Phone

(207) 487-9293

NPI assigned

Oct 8, 2010

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Function First Therapy LLC

  • Occupational Therapist
  • Plymouth, ME
  • NPI 1154094506
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1144530122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MT VIEW DR",
            "city": "PLYMOUTH",
            "state": "ME",
            "postal_code": "049693235",
            "telephone_number": "207-416-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LEIGHTON ST",
            "city": "PITTSFIELD",
            "state": "ME",
            "postal_code": "049673718",
            "telephone_number": "207-487-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "KELLYE",
        "middle_name": "ANN",
        "credential": "OT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "TO2446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Terranova, PHARMD
• Trunorth Optometry PLLC
• Alexa Varnum
• Walgreen Eastern Co Inc (Walgreens #17332)
• Waltz Pharmacy, Inc (Pittsfield Pharmacy)
• West Chiropractic LLC
• Jeremy West, DC
• Paul K West, DC
• Sarah Reeves Williams, LCSW
• Amy L Wing Stevens, OTR/L

• Occupational Therapist in Pittsfield, ME
• Providers in Pittsfield, ME by specialty
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.