Active NPI
Kelly Small, COTA
- Occupational Therapy Assistant
- Manchester, NH
National Provider Identifier
1396263364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 0767
- Practice address
- 235 Myrtle St
Manchester, NH 03104-4314 - Phone
- (603) 627-3811
- NPI assigned
- Aug 30, 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 Therapy Assistant | 224Z00000X | 0767 | NH | Primary |
Addresses
Primary practice location
235 Myrtle St
Manchester, NH 03104-4314
Mailing address
76 New London Dr
Webster, NH 03303-7921
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 |
|---|---|---|---|
| 0767 | NH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504051200000",
"number": "1396263364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 NEW LONDON DR",
"city": "WEBSTER",
"state": "NH",
"postal_code": "033037921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 MYRTLE ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044314",
"telephone_number": "603-627-3811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALL",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-30",
"last_updated": "2017-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NH",
"license": "0767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.