Jordan Kelley, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5604 Issued in OK

Practice address

3223 E 31St St
Tulsa, OK 74105-2452

Phone

(918) 250-9976

NPI assigned

Nov 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Therapysource for Kids, Inc.

  • Hearing and Speech Clinic/Center
  • Tulsa, OK
  • NPI 1447395033

  Pediatrics

  NPD
• Speech and Beyond, LLC

  • Speech-Language Pathologist
  • Jenks, OK
  • NPI 1457671919
  NPD (past)

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1174288500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7224 S ELWOOD AVE APT 5202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741322415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052452",
            "telephone_number": "918-250-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JORDAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OK",
            "license": "5604",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "5604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST LICENSE",
            "identifier": "5604",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelley@therapytown.com",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "TherapySource for Kids, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3223 E 31st St",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741052452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Keller
• Ammie Wall Kelley
• Ashley Marie Kelley, LCSW
• Beverly Kay Kelley, RD,LD,CDE
• Carla Ann Kelley
• Joshua Kelley, D.P.T.
• Kelli Dawn Kelley, OT
• Keneshia Dawn Kelley, M.ED
• Kim Kelley
• Michelle Kelley, M.D.

• Occupational Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.