Individual provider Active NPI

Kelsey Elizabeth Humbers, OTR/L

  • Occupational Therapist
  • Snellville, GA
National Provider Identifier
1144786955
Registry record updated Feb 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007266 Issued in GA
Practice address
2346 Wisteria Dr Ste 220
Snellville, GA 30078-6174
Phone
(912) 520-0915
NPI assigned
Feb 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2019

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 OT007266 GA Primary

Addresses

Primary practice location

2346 Wisteria Dr Ste 220
Snellville, GA 30078-6174

Mailing address

61 W Jerome St
Homerville, GA 31634-2210
Phone (912) 520-0915

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT007266GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1550361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550361600000",
    "number": "1144786955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 W JEROME ST",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342210",
            "telephone_number": "912-520-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 WISTERIA DR STE 220",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786174",
            "telephone_number": "912-520-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBERS",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-17",
        "last_updated": "2019-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2019; 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.