Individual provider Active NPI

Kristen D Kelly, OTR/L

  • Occupational Therapist
  • Crestview Hills, KY
National Provider Identifier
1265942809
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
132739 Issued in KY
Practice address
2865 Chancellor Dr Ste 105
Crestview Hills, KY 41017-3913
Phone
(859) 426-5666
Fax
(859) 426-5665
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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 132739 KY Primary

Addresses

Primary practice location

2865 Chancellor Dr Ste 105
Crestview Hills, KY 41017-3913

Mailing address

207 Dudley Pike
Edgewood, KY 41017-2674
Phone (859) 743-6133

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
132739KYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1265942809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 DUDLEY PIKE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410172674",
            "telephone_number": "859-743-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 CHANCELLOR DR STE 105",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173913",
            "telephone_number": "859-426-5666",
            "fax_number": "859-426-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KRISTEN",
        "middle_name": "D",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "132739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.