Active NPI
Erica Kelly, MOT OTR/L
- Occupational Therapist
- Seymour, CT
National Provider Identifier
1255847851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 004588
- Practice address
- 17 Sagamore Drive
Seymour, CT 06483 - Phone
- (203) 231-4831
- NPI assigned
- Dec 18, 2017
- Last updated
- Dec 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | 004588 | CT | Primary |
Addresses
Primary practice location
17 Sagamore Drive
Seymour, CT 06483
Mailing address
17 Sagamore Drive
Seymour, CT 06483
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 |
|---|---|---|---|
| 004588 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1255847851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 SAGAMORE DRIVE",
"city": "SEYMOUR",
"state": "CT",
"postal_code": "06483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 SAGAMORE DRIVE",
"city": "SEYMOUR",
"state": "CT",
"postal_code": "06483",
"telephone_number": "203-231-4831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "ERICA",
"credential": "MOT OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-18",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "004588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seymour, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.