Individual provider Active NPI

Kelly L Tuzzio, MOT, OTR/L

  • Pediatric Occupational Therapist
  • Mount Juliet, TN
National Provider Identifier
1295908531
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT00000005098 Issued in TN
Practice address
3690 N Mount Juliet Rd
Ste 400
Mount Juliet, TN 37122-3181
Phone
(615) 758-4888
Fax
(615) 758-6188
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT00000005098 TN Primary

Addresses

Primary practice location

3690 N Mount Juliet Rd
Ste 400
Mount Juliet, TN 37122-3181

Mailing address

413 Laurel Hills Dr
Mount Juliet, TN 37122-8407
Phone (614) 580-2128

Other identifiers 1

IdentifierTypeStateIssuer
0094740MedicaidOH

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
OT00000005098TNMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1295908531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 LAUREL HILLS DR",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371228407",
            "telephone_number": "614-580-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 N MOUNT JULIET RD",
            "address_2": "STE 400",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223181",
            "telephone_number": "615-758-4888",
            "fax_number": "615-758-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUZZIO",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "OT00000005098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.