Corinne Nicole Kelly, MS, OTR/L

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

0119007846 Issued in VA

Practice address

14370 Lee Hwy Ste 104
Gainesville, VA 20155-4865

Phone

(703) 565-4115

Fax

(703) 754-4435

NPI assigned

Sep 8, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1467935262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14029 BREEDERS CUP DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553142",
            "telephone_number": "703-565-4115",
            "fax_number": "703-754-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14370 LEE HWY STE 104",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554865",
            "telephone_number": "703-565-4115",
            "fax_number": "703-754-4435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10560 Main St Ste 417",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220307174",
            "country_code": "US",
            "telephone_number": "703-565-4115",
            "fax_number": "703-754-4435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CORINNE",
        "middle_name": "NICOLE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "VA",
            "license": "0119007846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hand Occupational Therapist in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Hand Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.