Individual provider Active NPI

Keriann S Wilmot, OTRL

  • Pediatric Occupational Therapist
  • Salem, MA
National Provider Identifier
1528187580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
7980 Issued in MA
Practice address
57 Highland Ave
Salem, MA 01970-2141
Phone
(978) 354-2746
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 7980 MA Primary

Addresses

Primary practice location

57 Highland Ave
Salem, MA 01970-2141

Mailing address

155 Washington St Apt 4
Haverhill, MA 01832-5465

Other names 1

  • Ms. Keriann Sullivan Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528187580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WASHINGTON ST APT 4",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018325465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702141",
            "telephone_number": "978-354-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "KERIANN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "7980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERIANN",
            "last_name": "SULLIVAN",
            "prefix": "MS.",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.