Active NPI
Kim Lorraine Willey, OTR/L
- Occupational Therapist
- Plymouth, NH
National Provider Identifier
1154609303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1997
- Practice address
- 607 Tenney Mountain Hwy Ste 144
Plymouth, NH 03264-3156 - Phone
- (603) 455-9646
- NPI assigned
- Jul 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3257 | NH | |
| Occupational Therapist | 225X00000X | 1997 | NH | Primary |
Addresses
Primary practice location
607 Tenney Mountain Hwy Ste 144
Plymouth, NH 03264-3156
Mailing address
961 Dana Hill Rd
New Hampton, NH 03256-4534
Phone (603) 455-9646
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1997 | NH | MD | Clinical Social Worker |
| 3257 | NH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1154609303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "961 DANA HILL RD",
"city": "NEW HAMPTON",
"state": "NH",
"postal_code": "032564534",
"telephone_number": "603-455-9646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 TENNEY MOUNTAIN HWY STE 144",
"city": "PLYMOUTH",
"state": "NH",
"postal_code": "032643156",
"telephone_number": "603-455-9646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEY",
"first_name": "KIM",
"middle_name": "LORRAINE",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-21",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NH",
"license": "3257",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NH",
"license": "1997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.