Active NPI
Madeline R Kelly, OTD, OTR/L
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1376061648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 16828
- Practice address
- 2230 Lake View Ave
Los Angeles, CA 90039-3636 - Phone
- (240) 676-0004
- Fax
- (240) 676-0004
- NPI assigned
- Sep 6, 2017
- Last updated
- Sep 6, 2017
- 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 | 16828 | CA | Primary |
Addresses
Primary practice location
2230 Lake View Ave
Los Angeles, CA 90039-3636
Mailing address
2230 Lake View Ave
Los Angeles, CA 90039-3636
Phone (240) 676-0004
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504656000000",
"number": "1376061648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2230 LAKE VIEW AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900393636",
"telephone_number": "240-676-0004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 LAKE VIEW AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900393636",
"telephone_number": "240-676-0004",
"fax_number": "240-676-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MADELINE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-06",
"last_updated": "2017-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "16828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.