Active NPI
Kelli A Anderson
- Occupational Therapist
- Birmingham, AL
National Provider Identifier
1295748945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1783
- Practice address
- 805 Saint Vincents Dr
Suite a
Birmingham, AL 35205-1636 - Phone
- (205) 212-9435
- Fax
- (205) 212-3299
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 1783 | AL | Primary |
Addresses
Primary practice location
805 Saint Vincents Dr
Suite a
Birmingham, AL 35205-1636
Mailing address
805 Saint Vincents Dr
Suite a
Birmingham, AL 35205-1636
Phone (205) 212-9435
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630648108469PT | Other | AL | VIVA |
| 051535137 | Other | AL | BCBS OF AL |
| 60640 | Other | AL | BCBS OF AL |
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 |
|---|---|---|---|
| 1783 | AL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1295748945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 SAINT VINCENTS DR",
"address_2": "SUITE A",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352051636",
"telephone_number": "205-212-9435",
"fax_number": "205-212-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 SAINT VINCENTS DR",
"address_2": "SUITE A",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352051636",
"telephone_number": "205-212-9435",
"fax_number": "205-212-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KELLI",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "1783",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "630648108469PT",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "051535137",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "60640",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.