Active NPI
Courtney Ann Kelly, OTR/L
- Occupational Therapist
- Hunt Valley, MD
National Provider Identifier
1386393130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14068
- Practice address
- 307 International Cir Ste 100
Hunt Valley, MD 21030-1387 - Phone
- (410) 667-7200
- NPI assigned
- Mar 21, 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 14068 | MA | Primary |
Addresses
Primary practice location
307 International Cir Ste 100
Hunt Valley, MD 21030-1387
Mailing address
830 Patriots Rd
Templeton, MA 01468-1303
Phone (978) 895-9776
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 |
|---|---|---|---|
| 14068 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1386393130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 PATRIOTS RD",
"city": "TEMPLETON",
"state": "MA",
"postal_code": "014681303",
"telephone_number": "978-895-9776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 INTERNATIONAL CIR STE 100",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "210301387",
"telephone_number": "410-667-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "COURTNEY",
"middle_name": "ANN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-21",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "14068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hunt Valley, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.