Kelly Grote Matutina, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119002058 Issued in VA

Practice address

650 N Jefferson St
Roanoke, VA 24016-1427

Phone

(540) 345-5111

NPI assigned

Jun 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1174817043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 MEADOWCREST ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194816",
            "telephone_number": "928-234-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240161427",
            "telephone_number": "540-345-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUTINA",
        "first_name": "KELLY",
        "middle_name": "GROTE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119002058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Hope Matossian, PA-C
• Eka Matsumoto
• Kimberly A Matthews, D.O.
• Colleen James Mattocks, DO
• Akirah Monaye Mattox
• Andrew Jason Matzner, L.C.S.W.
• Shagufta Maududi, MD
• Lauren Maule, OTR/L
• Travis Wade Maule, MSN, APRN, FNP-C
• Rebecca Lynn Maupin, RN

• Occupational Therapist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.