Individual provider Active NPI

Kelly Regan, MA OTR/L

  • Pediatric Occupational Therapist
  • Springfield, MA
National Provider Identifier
1245307511
Registry record updated Aug 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
9299 Issued in MA
Practice address
127 Forest Park Ave
Springfield, MA 01108-2005
Phone
(860) 539-5571
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 9299 MA Primary
Occupational Therapist 225X00000X 9299 MA

Addresses

Primary practice location

127 Forest Park Ave
Springfield, MA 01108-2005

Mailing address

127 Forest Park Ave
Springfield, MA 01108-2005

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
9299MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250985600000",
    "number": "1245307511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 FOREST PARK AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011082005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 FOREST PARK AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011082005",
            "telephone_number": "860-539-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "MA OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "9299",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "9299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2009; 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.