Kelly Matakovic, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

274237 Issued in KY

Practice address

1311 Herr LN Ste 205
Louisville, KY 40222-4384

Phone

(502) 419-7811

NPI assigned

Jan 19, 2022

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

Locations

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.

• Pediatric Solutions PLLC

  • Occupational Therapist
  • Louisville, KY
  • NPI 1831068303
  NPD

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1316699630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 HERR LN STE 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224384",
            "telephone_number": "502-419-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 HERR LN STE 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224384",
            "telephone_number": "502-419-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAKOVIC",
        "first_name": "KELLY",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "274237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Masterson, OTR/L
• Masterson'S Food & Drink
• Nicholas A Mastoroudis
• Jaclyn Masucci
• Mat Prac Group, LLC
• Christian Matar
• Scott Matash, OTRL
• Mohammad Fahmi Mathbout, MBBS
• Elizabeth Ann Matheney, DNP, AGACNP-BC
• Stephanie Matheney

• Occupational Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.