Active NPI
Kelsy Lyn Gumbert
- Pediatric Occupational Therapist
- Tampa, FL
National Provider Identifier
1336871979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 23130
- Practice address
- 5126 Net Dr # 3-220
Tampa, FL 33634-5095 - Phone
- (215) 307-0019
- NPI assigned
- Jun 30, 2022
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 23130 | FL | Primary |
Addresses
Primary practice location
5126 Net Dr # 3-220
Tampa, FL 33634-5095
Mailing address
5126 Net Dr # 3-220
Tampa, FL 33634-5095
Phone (215) 307-0019
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23130 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1336871979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5126 NET DR # 3-220",
"city": "TAMPA",
"state": "FL",
"postal_code": "336345095",
"telephone_number": "215-307-0019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5126 NET DR # 3-220",
"city": "TAMPA",
"state": "FL",
"postal_code": "336345095",
"telephone_number": "215-307-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUMBERT",
"first_name": "KELSY",
"middle_name": "LYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-30",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "23130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.