Stephen Patrick Kelly, COTA

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

7141919 Issued in NY

Practice address

6080 Jericho Tpke Ste 200
Commack, NY 11725-2808

Phone

(631) 979-7224

Fax

(631) 979-7224

NPI assigned

Sep 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1457601098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 WESTWOOD LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117545122",
            "telephone_number": "631-979-7224",
            "fax_number": "631-979-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE STE 200",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252808",
            "telephone_number": "631-979-7224",
            "fax_number": "631-979-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "NY",
            "license": "7141919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kekatos Podiatry P.C.
• Colleen Kelly, P.A.
• Dejon Paul Kelly
• Laura Jean Kelly, RD, CSO, CDN
• Maureen Jeanette Kelly, P.A.
• Andrea Michelle Keltos, LMSW
• Bethany H Kennedy, ANP, MSN, RN
• Gregory Wayne Kennedy, DDS
• Regina Kent, OTR/L
• Shannon L Kerekes, MS OTR/L

• Mechanotherapist in Commack, NY
• Providers in Commack, NY by specialty
• Mechanotherapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.