Active NPI
Kellie Tysor
- Occupational Therapist
- Pasadena, MD
National Provider Identifier
1508277591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 03101
- Practice address
- 334 Bar Harbor Road
Pasadena, MD 21122 - Phone
- (410) 218-3215
- NPI assigned
- May 13, 2014
- Last updated
- May 13, 2014
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 03101 | MD | Primary |
Addresses
Primary practice location
334 Bar Harbor Road
Pasadena, MD 21122
Mailing address
334 Bar Harbor Road
Pasadena, MD 21122
Phone (410) 218-3215
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 |
|---|---|---|---|
| 03101 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399939200000",
"number": "1508277591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 BAR HARBOR ROAD",
"city": "PASADENA",
"state": "MD",
"postal_code": "21122",
"telephone_number": "410-218-3215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 BAR HARBOR ROAD",
"city": "PASADENA",
"state": "MD",
"postal_code": "21122",
"telephone_number": "410-218-3215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYSOR",
"first_name": "KELLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-13",
"last_updated": "2014-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "03101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, MD
- Trusted Doctors LLC
- Lucyna Trzeciak, PHARMD
- Yvonne Tshibombi Tubene, FNP
- Turning Stone Counseling LLC
- Patricia Marie Tyler, ADT
- Ulery Dental and Orthodontics
- Umms Ambulatory Care LLC (University of Maryland Urgent Care- Pasadena)
- Utietiang Stanley Unimna, CSW
- United Radiology Services, LLC
- University of Maryland Community Medical Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.