Individual provider Active NPI

Keeli McCracken, OTR

  • Occupational Therapist
  • Bryan, TX
National Provider Identifier
1154677383
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
114472 Issued in TX
Practice address
1318 Memorial Dr
Bryan, TX 77802-5215
Phone
(979) 776-2872
Fax
(979) 776-1456
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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 114472 TX Primary

Addresses

Primary practice location

1318 Memorial Dr
Bryan, TX 77802-5215

Mailing address

1318 Memorial Dr
Bryan, TX 77802-5215

Other names 1

  • Keeli Warford Former name

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

State licenses

LicenseStateTypeSpecialty
114472TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1154677383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215",
            "telephone_number": "979-776-2872",
            "fax_number": "979-776-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "KEELI",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEELI",
            "last_name": "WARFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.