Individual provider Active NPI

Kellie Tekulve, MOTR

  • Pediatric Occupational Therapist
  • Indianapolis, IN
National Provider Identifier
1184019044
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
31005832A Issued in IN
Practice address
6239 S East St
Indianapolis, IN 46227-2090
Phone
(317) 791-9031
Fax
(317) 791-9001
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31005832A IN
Pediatric Occupational Therapist 225XP0200X 31005832A IN Primary

Addresses

Primary practice location

6239 S East St
Indianapolis, IN 46227-2090

Mailing address

6239 S East St
Indianapolis, IN 46227-2090
Phone (317) 791-9031

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
31005832AINMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1184019044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272090",
            "telephone_number": "317-791-9031",
            "fax_number": "317-791-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272090",
            "telephone_number": "317-791-9031",
            "fax_number": "317-791-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKULVE",
        "first_name": "KELLIE",
        "name_prefix": "Ms.",
        "credential": "MOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005832A",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31005832A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.