Active NPI
Kelley Elise Villegas, OTR
- Neurorehabilitation Occupational Therapist
- Lake Mary, FL
National Provider Identifier
1508007709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurorehabilitation Occupational Therapist
- License
- OT17692
- Practice address
- 255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168 - Phone
- (407) 951-4280
- Fax
- (407) 804-9769
- NPI assigned
- Mar 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | OT17692 | FL | Primary |
Addresses
Primary practice location
255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168
Mailing address
255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168
Phone (407) 362-1902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT17692 | FL | MD | Neurorehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741651200000",
"number": "1508007709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 PRIMERA BLVD STE 160",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462168",
"telephone_number": "407-362-1902",
"fax_number": "407-804-9769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 PRIMERA BLVD STE 160",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462168",
"telephone_number": "407-951-4280",
"fax_number": "407-804-9769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLEGAS",
"first_name": "KELLEY",
"middle_name": "ELISE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-18",
"last_updated": "2025-03-11",
"certification_date": "2025-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "FL",
"license": "OT17692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.