Kellie Lynn Reno, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008444 Issued in MI

Practice address

500 E University Dr
Rochester, MI 48307-7206

Phone

(517) 250-0317

NPI assigned

Mar 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kellie Lynn Whitaker Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366

  Occupational Therapist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1275036899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 COLONY DR",
            "city": "CLAY",
            "state": "MI",
            "postal_code": "480014115",
            "telephone_number": "517-250-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E UNIVERSITY DR",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483077206",
            "telephone_number": "517-250-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENO",
        "first_name": "KELLIE",
        "middle_name": "LYNN",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "WHITAKER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gopal Reddy, MD
• Kala Gopal Reddy, M.D.
• Brian K Reedy, M.D.
• Regents of the Univ of Michigan Heart Surgery Program Critteton
• Kevin Rem, LPC
• Requiem, LLC
• Res-Care Premier, Inc.
• Rescare Home Care Michigan
• Rescare Premier Inc
• Resilient Roots LLC

• Occupational Therapist in Rochester, MI
• Providers in Rochester, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.