Active NPI
Colleen Kelley, C.O.T.A.
- Occupational Therapy Assistant
- Utica, NY
National Provider Identifier
1215575709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 006513-1
- Practice address
- 130 Lomond CT
Utica, NY 13502-5957 - Phone
- (315) 724-4286
- NPI assigned
- Dec 15, 2019
- 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 Therapy Assistant | 224Z00000X | 006513-1 | NY | Primary |
Addresses
Primary practice location
130 Lomond CT
Utica, NY 13502-5957
Mailing address
PO Box 542
Heuvelton, NY 13654-0542
Phone (315) 854-7243
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 |
|---|---|---|---|
| 006513-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576368000000",
"number": "1215575709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 542",
"city": "HEUVELTON",
"state": "NY",
"postal_code": "136540542",
"telephone_number": "315-854-7243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 LOMOND CT",
"city": "UTICA",
"state": "NY",
"postal_code": "135025957",
"telephone_number": "315-724-4286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "COLLEEN",
"credential": "C.O.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-15",
"last_updated": "2019-12-15",
"certification_date": "2019-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "006513-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.