Active NPI
Kyra Spencer, OTR/L
- Occupational Therapist
- Broomall, PA
National Provider Identifier
1346966033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC018057
- Practice address
- 103 Bella Dr
Broomall, PA 19008-1505 - Phone
- (610) 551-8172
- NPI assigned
- Oct 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | OC018057 | PA | Primary |
Addresses
Primary practice location
103 Bella Dr
Broomall, PA 19008-1505
Mailing address
103 Bella Dr
Broomall, PA 19008-1505
Phone (610) 551-8172
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 |
|---|---|---|---|
| OC018057 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1346966033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 BELLA DR",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190081505",
"telephone_number": "610-551-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 BELLA DR",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190081505",
"telephone_number": "610-551-8172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "KYRA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-14",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC018057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.