Kelly Lynn Wilson, MS, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009535 Issued in MI

Practice address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Phone

(248) 898-5000

NPI assigned

Feb 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Lynn Bridge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1519430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1407357403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 DREON DR",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171014",
            "telephone_number": "313-820-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7508 M E Cad Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483484281",
            "country_code": "US",
            "telephone_number": "248-922-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "MS, OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-24",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BRIDGE",
            "middle_name": "LYNN",
            "credential": "MS, OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin E Wilson, FNP-BC
• Franchesta Merritt Wilson, LPC
• Jennifer Wilson
• Jennifer Alice Wilson
• John Douglas Wilson, M.S.W.
• Melissa Wilson
• Rebecca Wilson
• Tara Shewre Wilson, NURSE PRACTITIONER
• Yelena Wilson, D.O.
• Penny Wilton, MD

• Occupational Therapist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.