Individual provider Active NPI

Mackenzie Coleman Pelphrey

  • Occupational Therapist
  • Russell Springs, KY
National Provider Identifier
1477343465
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
299321 Issued in KY
Practice address
2465 Lakeway Dr
Russell Springs, KY 42642-4510
Phone
(606) 677-1166
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 299321 KY Primary

Addresses

Primary practice location

2465 Lakeway Dr
Russell Springs, KY 42642-4510

Mailing address

303 Second St
Somerset, KY 42501-2390

Other practice location 1

303 Second St
Somerset, KY 42501-2390
Phone (606) 677-1166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260217001590 KY Practitioner - Occupational Therapist in Private Practice 0244710424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

194 Fairway LN
Apt a
Somerset, KY 42503-3461

303 2ND St
Somerseet, KY 42501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299321KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Futures Therapy Center, LLC CurrentSince Jan 7, 2026 Accepting new patients

Locations

303 Second St
Somerset, KY 42501
Phone (606) 451-9672

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1477343465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SECOND ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 LAKEWAY DR",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424510",
            "telephone_number": "606-677-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Second St",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425012390",
            "country_code": "US",
            "telephone_number": "606-677-1166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELPHREY",
        "first_name": "MACKENZIE",
        "middle_name": "COLEMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "299321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.