Nicole B. Keniston

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT3968 Issued in ME

Practice address

152 US-1
Scarborough, ME 04074

Phone

(207) 883-5882

NPI assigned

Jul 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1598338154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GOSHEN RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040626309",
            "telephone_number": "078-076-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 US-1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-883-5882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 State House Sta",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043339192",
            "country_code": "US",
            "telephone_number": "207-624-6660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENISTON",
        "first_name": "NICOLE",
        "middle_name": "B.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT3968",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ME",
            "license": "OT3968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OT3968",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Eugene Keller, RPH
• Mirle A Kellett, M.D.
• Lindsey Kelley, MS, CGC
• Liana Belle Kelly, FNP
• Sarah E. Kelsik, LCSW
• Ashley Kennes, MS, CGC
• Emily I Kenny, MD
• Rebecca Anne Kenny
• Thabo Kenosi, MD
• Christine Kerr, DO

• Pediatric Occupational Therapist in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Pediatric Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.