Active NPI
Keli Lynn McHale, OTR
- Occupational Therapist
- West Columbia, SC
National Provider Identifier
1417024167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 612
- Practice address
- 2705 Leaphart Rd
Agape Therapy
West Columbia, SC 29169-3335 - Phone
- (803) 926-5119
- NPI assigned
- Nov 29, 2006
- 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 | 612 | SC | Primary |
Addresses
Primary practice location
2705 Leaphart Rd
Agape Therapy
West Columbia, SC 29169-3335
Mailing address
120 Whispering Glen Cir
West Columbia, SC 29170-2764
Phone (803) 739-9311
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 612 | SC | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417024167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 WHISPERING GLEN CIR",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291702764",
"telephone_number": "803-739-9311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 LEAPHART RD",
"address_2": "AGAPE THERAPY",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693335",
"telephone_number": "803-926-5119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCHALE",
"first_name": "KELI",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.