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

Last updated

May 12, 2022By the provider in NPPES

Sex

Female

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

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthpro Heritage Rehab & Fitness, LLC

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  Occupational Therapist

  Medicare reassignment NPD
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  • Physical Therapist
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  • NPI 1871072462

  Occupational Therapist

  NPD

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

{
    "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
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• 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

• Occupational Therapist in Mt Washington, KY
• Providers in Mt Washington, KY by specialty
• 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.