Individual provider Active NPI

Kelsey Edwards, CTRS

  • Recreation Therapist
  • Poland, OH
National Provider Identifier
1346970134
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
License
69913 Issued in OH
Practice address
200 Marion Dr
Poland, OH 44514-3734
Phone
(330) 881-4054
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X 69913 OH Primary

Addresses

Primary practice location

200 Marion Dr
Poland, OH 44514-3734

Mailing address

200 Marion Dr
Poland, OH 44514-3734

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

LicenseStateTypeSpecialty
69913OHMDRecreation Therapist

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1346970134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARION DR",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARION DR",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143734",
            "telephone_number": "330-881-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KELSEY",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "OH",
            "license": "69913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

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

Verify at the official NPI Registry.