Kelly Pruett, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002478 Issued in OH

Practice address

6200 Whipple Ave NW
North Canton, OH 44720-7624

Phone

(330) 966-8614

NPI assigned

May 23, 2007

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

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1467662825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4167 GEORGIA ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446463266",
            "telephone_number": "330-477-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207624",
            "telephone_number": "330-966-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "KELLY",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT002478",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OH",
            "license": "OT 002478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela S Propst, COTA/L
• Angela Proski, COTA/L
• Protech Security, Inc.
• Providence Nursing Services Inc. (Community Caregivers of Green Nursing Services)
• Providence Senior Transportation Inc.
• Steven R Pruett, PH.D.
• Jerrice Shayonne Pue Baker
• Zoe Lin Pullar, DPT
• Kelsey Ann Puma
• Deborah A Punshon, PA-C

• Occupational Therapist in North Canton, OH
• Providers in North Canton, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.