Kelsey Dante Rizzo, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

243483 Issued in KY

Practice address

58 Eastham St
Vanceburg, KY 41179-5462

Phone

(606) 796-3046

NPI assigned

Jul 2, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Grayson Speech Therapy

  • Early Intervention Provider Agency
  • Grayson, KY
  • NPI 1194902668
  NPD (past)

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1306408166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 VICE ST",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411797837",
            "telephone_number": "606-202-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 EASTHAM ST",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411795462",
            "telephone_number": "606-796-3046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 Windburn Ln",
            "address_purpose": "LOCATION",
            "city": "Grayson",
            "state": "KY",
            "postal_code": "411438372",
            "country_code": "US",
            "telephone_number": "606-922-2572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIZZO",
        "first_name": "KELSEY",
        "middle_name": "DANTE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "243483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Vanceburg, KY
• Occupational Therapy Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.