Savannah Dawn Kelley, OTA

Individual provider Active NPI Occupational Therapy Assistant · Ellsworth, KS

NPI 1447516042 · NPPES record last updated Dec 11, 2020

Key facts

NPI
1447516042
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
18-00856 (KS)
Practice address
1156 Highway 14
Ellsworth, KS 67439-8661
Phone
(785) 472-3167
NPI assigned
Apr 9, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18-00856KSMDOccupational Therapy Assistant
T-03189KSMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X T-03189 KS
Occupational Therapy Assistant 224Z00000X 18-00856 KS Yes

Addresses

Primary practice location

1156 Highway 14
Ellsworth, KS 67439-8661

Mailing address

202 S Colorado St
Kanopolis, KS 67454-0091

Electronic endpoints

TypeEndpointUseAffiliation
Other URL ellsworth@summitcare.net Health Information Exchange (HIE)

Other providers in Ellsworth, KS

All providers in Ellsworth, KS · Occupational Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.