Active NPI
Kaylyn Ellis, MOTR/L
- Occupational Therapist
- Draper, UT
National Provider Identifier
1316388564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6717450-4201
- Practice address
- 12453 S 265 W Ste B
Draper, UT 84020 - Phone
- (801) 443-7775
- Fax
- (801) 447-0107
- NPI assigned
- Jul 16, 2013
- 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 | 6717450-4201 | UT | Primary |
Addresses
Primary practice location
12453 S 265 W Ste B
Draper, UT 84020
Mailing address
PO Box 363
Riverton, UT 84065-0363
Phone (801) 443-7775
Other practice location 1
9384 S 670 W
Sandy, UT 84070-6667
Phone (800) 472-9515
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1316388564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 363",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840650363",
"telephone_number": "801-443-7775",
"fax_number": "801-447-0107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12453 S 265 W STE B",
"city": "DRAPER",
"state": "UT",
"postal_code": "84020",
"telephone_number": "801-443-7775",
"fax_number": "801-447-0107"
}
],
"practiceLocations": [
{
"address_1": "9384 S 670 W",
"address_purpose": "LOCATION",
"city": "Sandy",
"state": "UT",
"postal_code": "840706667",
"country_code": "US",
"telephone_number": "800-472-9515",
"fax_number": "801-447-0107",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "KAYLYN",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-16",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "UT",
"license": "6717450-4201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.