Individual provider Active NPI

Kelly A Nesbitt, OTR/L, CAPS, ECHM

  • Gerontology Occupational Therapist
  • Portland, OR
National Provider Identifier
1508193830
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
1036721 Issued in OR
Practice address
8564 N Richmond Ave
Portland, OR 97203
Phone
(503) 673-6299
NPI assigned
Nov 6, 2009
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 1036721 OR Primary

Addresses

Primary practice location

8564 N Richmond Ave
Portland, OR 97203

Mailing address

8564 N Richmond Ave
Portland, OR 97203
Phone (503) 673-6299

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

LicenseStateTypeSpecialty
1036721ORMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Rehab, LLC PastSince Mar 1, 2005 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1508193830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8564 N RICHMOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97203",
            "telephone_number": "503-673-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8564 N RICHMOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97203",
            "telephone_number": "503-673-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESBITT",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "OTR/L, CAPS, ECHM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "OR",
            "license": "1036721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.