Individual provider Active NPI

Kerri Costello, OTR/L

  • Occupational Therapist
  • Mansfield, MA
National Provider Identifier
1154755718
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2016 Issued in MA
Practice address
4 Samoset Ave
Mansfield, MA 02048-2237
Phone
(508) 208-8438
NPI assigned
Aug 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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 2016 MA Primary

Addresses

Primary practice location

4 Samoset Ave
Mansfield, MA 02048-2237

Mailing address

156 Lovering Street
Medway, MA 02053
Phone (508) 533-6181

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
2016MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1154755718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 LOVERING STREET",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "02053",
            "telephone_number": "508-533-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SAMOSET AVE",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020482237",
            "telephone_number": "508-208-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "KERRI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.