Active NPI
Kelly Moore, OTR/L
- Occupational Therapist
- Westfield, MA
National Provider Identifier
1174840698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7579
- Practice address
- 209 Root Rd
Suite #2
Westfield, MA 01085-9832 - Phone
- (413) 568-3942
- Fax
- (413) 568-5983
- NPI assigned
- Apr 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 7579 | MA | Primary |
Addresses
Primary practice location
209 Root Rd
Suite #2
Westfield, MA 01085-9832
Mailing address
209 Root Rd
Suite #2
Westfield, MA 01085-9832
Phone (413) 568-3942
Other names 1
- Kelly Wooldridge
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7579 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271980800000",
"number": "1174840698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 ROOT RD",
"address_2": "SUITE #2",
"city": "WESTFIELD",
"state": "MA",
"postal_code": "010859832",
"telephone_number": "413-568-3942",
"fax_number": "413-568-5983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 ROOT RD",
"address_2": "SUITE #2",
"city": "WESTFIELD",
"state": "MA",
"postal_code": "010859832",
"telephone_number": "413-568-3942",
"fax_number": "413-568-5983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KELLY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-23",
"last_updated": "2010-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "7579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "WOOLDRIDGE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Westfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.