Kaelyn Broell, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

277298 Issued in KY

Practice address

520 Woodlake Dr
Mount Washington, KY 40047-5123

Phone

(502) 538-3172

NPI assigned

May 12, 2022

Sex

Female

Sole proprietor

Yes

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Louisville, KY
  • NPI 1770054686

  KY, Occupational Therapist

  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 12, 2022.

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1467199331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 N HOWARD ST",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400048115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WOODLAKE DR",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400475123",
            "telephone_number": "502-538-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROELL",
        "first_name": "KAELYN",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "277298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluergrass Services of Ky LLC
• Bluewater Toxicology LLC
• Jennifer Louise Bowen
• Jamie Bowlds, PHARMD
• James Philip Bowles, DC
• Deanna Marie Brown
• Abigail Bruce
• Tina Bryant, PT
• Janice Buchanan, P.T.
• Cortney L Buse

• All providers in Mount Washington, KY
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.