Active NPI
Melissa Kennard, OTR/L
- Occupational Therapist
- Wurtland, KY
National Provider Identifier
1417314568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- R3507
- Practice address
- 100 Wurtland Ave
Wurtland, KY 41144-1445 - Phone
- (606) 836-0931
- NPI assigned
- Jan 20, 2016
- Last updated
- Jan 20, 2016
- 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 | R3507 | KY | Primary |
Addresses
Primary practice location
100 Wurtland Ave
Wurtland, KY 41144-1445
Mailing address
148 Camelot CT
Russell, KY 41169-1624
Phone (740) 357-5408
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 |
|---|---|---|---|
| R3507 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453248000000",
"number": "1417314568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 CAMELOT CT",
"city": "RUSSELL",
"state": "KY",
"postal_code": "411691624",
"telephone_number": "740-357-5408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WURTLAND AVE",
"city": "WURTLAND",
"state": "KY",
"postal_code": "411441445",
"telephone_number": "606-836-0931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNARD",
"first_name": "MELISSA",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-20",
"last_updated": "2016-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "R3507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wurtland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.