Kelly A Stafford, MOT, OTR/L, C/NDT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

016667-1 Issued in NY

Practice address

171 Madison Ave FL 5
New York, NY 10016

Phone

(212) 400-0383

NPI assigned

Mar 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stafford OT, PLLC

  • Pediatric Occupational Therapist
  • Brooklyn, NY
  • NPI 1790508414

  Multi-Specialty

  NPD Authorized official
• Ahrc Nyc

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1255715850
  NPD (past)
• The Sensory Motor Integration and Language Enrichment Therapeutic Serv

  dba The SMILE Center, PLLC

  • Early Intervention Provider Agency
  • New York, NY
  • NPI 1023248879

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1447558572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 1ST ST # 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112315002",
            "telephone_number": "516-860-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MADISON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-400-0383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2335 Gerritsen Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112295701",
            "country_code": "US",
            "telephone_number": "718-834-0597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "MOT, OTR/L, C/NDT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016667-1",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "016667-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Staebell, PT, DPT
• David A Staffenberg, MD
• Carly Staffin
• Brenda Stafford
• Jennifer L. Stafford, MA, EDM, LMHC
• Anfernee Steven Stage
• Madelaine Stager, L.AC.
• Stages Pediatrics P.C.
• Amy R Stagg, M.D.
• Gerald L. Stagg

• Pediatric Occupational Therapist in New York, NY
• Providers in New York, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.