Individual provider Active NPI

Kelly Toler, OT

  • Occupational Therapist
  • Byram, MS
National Provider Identifier
1225274962
Registry record updated Dec 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1535 Issued in MS
Practice address
7213 S Siwell Rd
Byram, MS 39272-9776
Phone
(601) 346-9191
Fax
(601) 346-5011
NPI assigned
Dec 31, 2008
Last updated
Dec 31, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2008

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 OT1535 MS Primary

Addresses

Primary practice location

7213 S Siwell Rd
Byram, MS 39272-9776

Mailing address

PO Box 720610
Byram, MS 39272-0610
Phone (601) 346-9191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726004123 MS Practitioner - Occupational Therapist in Private Practice 0749641595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab Agency Ms LLCGroup PAC ID 2769841782, 66 clinicians

Practice addresses (Care Compare)

Starkville, MS 39759
Phone (877) 407-3422

205 Industrial CV
Ridgeland, MS 39157-2715
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT1535MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Agency Ms LLC Occupational Therapist CurrentSince Jun 1, 2023 Accepting new patients
Performance Rehab, Inc Past Accepting new patients

Locations

74 Claiborne Way
Starkville, MS 39759
Phone (662) 268-9555

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1225274962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720610",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392720610",
            "telephone_number": "601-346-9191",
            "fax_number": "601-346-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7213 S SIWELL RD",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729776",
            "telephone_number": "601-346-9191",
            "fax_number": "601-346-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLER",
        "first_name": "KELLY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byram, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.