Individual provider Active NPI

Kristen Farrell, OTR/L

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1558638940
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
014501-1 Issued in NY
Practice address
472 Columbus Ave
1B
New York, NY 10024-5173
Phone
(347) 461-5109
NPI assigned
Nov 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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 014501-1 NY Primary

Addresses

Primary practice location

472 Columbus Ave
1B
New York, NY 10024-5173

Mailing address

472 Columbus Ave
1B
New York, NY 10024-5173

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
014501-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1558638940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 COLUMBUS AVE",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 COLUMBUS AVE",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245173",
            "telephone_number": "347-461-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "KRISTEN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014501-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.