Individual provider Active NPI

Denise Ellen Kelly, OT

  • Occupational Therapist
  • Newton, MA
National Provider Identifier
1245496652
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1926 Issued in MA
Practice address
400 Centre St
Newton, MA 02458-2094
Phone
(617) 796-8155
Fax
(617) 796-8291
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 1926 MA Primary

Addresses

Primary practice location

400 Centre St
Newton, MA 02458-2094

Mailing address

400 Centre St
Newton, MA 02458-2094
Phone (617) 796-8155

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
1926MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1245496652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582094",
            "telephone_number": "617-796-8155",
            "fax_number": "617-796-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582094",
            "telephone_number": "617-796-8155",
            "fax_number": "617-796-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DENISE",
        "middle_name": "ELLEN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "1926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.