Individual provider Active NPI

Ingrid Kenron

  • Occupational Therapist
  • Mooresville, NC
National Provider Identifier
1508193293
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056008849 Issued in IL
Practice address
134 Infield CT
Mooresville, NC 28117
Phone
(704) 799-6824
Fax
(704) 799-6825
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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 056008849 IL Primary

Addresses

Primary practice location

134 Infield CT
Mooresville, NC 28117

Mailing address

134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824

Other practice location 1

9440 Ozark Ave
Morton Grove, IL 60053-1063
Phone (847) 966-1505

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
056008849ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Therapy Concepts Past Accepting new patients
Lolly Therapeutics, LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1508193293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9440 Ozark Ave",
            "address_purpose": "LOCATION",
            "city": "Morton Grove",
            "state": "IL",
            "postal_code": "600531063",
            "country_code": "US",
            "telephone_number": "847-966-1505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENRON",
        "first_name": "INGRID",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.