Active NPI
Kelly Kennard, OTR
- Occupational Therapist
- Little Egg Harbor, NJ
National Provider Identifier
1285070862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00442900
- Practice address
- 1001 Center St
Little Egg Harbor, NJ 08087 - Phone
- (609) 857-4141
- NPI assigned
- May 22, 2013
- Last updated
- May 22, 2013
- 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 | 46TR00442900 | NJ | Primary |
Addresses
Primary practice location
1001 Center St
Little Egg Harbor, NJ 08087
Mailing address
155 Mizzen Ave
Manahawkin, NJ 08050-1920
Phone (609) 891-9720
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00442900 | NJ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1285070862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 MIZZEN AVE",
"city": "MANAHAWKIN",
"state": "NJ",
"postal_code": "080501920",
"telephone_number": "609-891-9720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 CENTER ST",
"city": "LITTLE EGG HARBOR",
"state": "NJ",
"postal_code": "08087",
"telephone_number": "609-857-4141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNARD",
"first_name": "KELLY",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-22",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00442900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Egg Harbor, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.