Individual provider Active NPI

Kellie Lea James, OTR/L

  • Occupational Therapist
  • Rebecca, GA
National Provider Identifier
1194383836
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006201 Issued in GA
Practice address
333 Zinnia Rd
Rebecca, GA 31783-5021
Phone
(941) 232-9161
NPI assigned
May 29, 2019
Last updated
May 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2019

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 OT006201 GA Primary

Addresses

Primary practice location

333 Zinnia Rd
Rebecca, GA 31783-5021

Mailing address

333 Zinnia Rd
Rebecca, GA 31783-5021
Phone (941) 232-9161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200110002620 GA Practitioner - Occupational Therapist in Private Practice 4486089943 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Oct 15, 2019 Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1194383836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ZINNIA RD",
            "city": "REBECCA",
            "state": "GA",
            "postal_code": "317835021",
            "telephone_number": "941-232-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 ZINNIA RD",
            "city": "REBECCA",
            "state": "GA",
            "postal_code": "317835021",
            "telephone_number": "941-232-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "KELLIE",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.