Active NPI
Donna Kelley, OTR
- Occupational Therapist
- Anchorage, AK
National Provider Identifier
1407025232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2624
- Practice address
- 161 Klevin St
Suite 103
Anchorage, AK 99508 - Phone
- (907) 561-8060
- Fax
- (907) 563-3172
- NPI assigned
- Feb 26, 2008
- 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 | 2624 | AK | Primary |
Addresses
Primary practice location
161 Klevin St
Suite 103
Anchorage, AK 99508
Mailing address
161 Klevin St
Suite 103
Anchorage, AK 99508
Phone (907) 561-8060
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111408402 | Medicaid | TX | |
| 112240 | Other | TX | HUMANA |
| 112240 | Other | TX | LICENSE # |
Other names 1
- Ms. Donna Bernard
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 |
|---|---|---|---|
| 2624 | AK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Programs for Infants & Children, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Occupational Therapist
- Anchorage, AK
- NPI 1164571238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1407025232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 KLEVIN ST",
"address_2": "SUITE 103",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "99508",
"telephone_number": "907-561-8060",
"fax_number": "907-563-3172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 KLEVIN ST",
"address_2": "SUITE 103",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "99508",
"telephone_number": "907-561-8060",
"fax_number": "907-563-3172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "DONNA",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-26",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "2624",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111408402",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "112240",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "112240",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DONNA",
"last_name": "BERNARD",
"prefix": "MS.",
"credential": "OTR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.