Individual provider Active NPI

Kelsey Carn Pinson, OTR/L

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1619217346
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
117780 Issued in TX
Practice address
5401 Lava Rock Dr
Fort Worth, TX 76179-7379
Phone
(817) 542-9418
NPI assigned
Feb 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8076 NC
Occupational Therapist 225X00000X 117780 TX Primary

Addresses

Primary practice location

5401 Lava Rock Dr
Fort Worth, TX 76179-7379

Mailing address

5401 Lava Rock Dr
Fort Worth, TX 76179-7379
Phone (817) 542-9418

Other practice location 1

215 Valencia Ct Unit 205
Wilmington, NC 28412-7079
Phone (843) 813-0868

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL kelseypinson14@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191021000531 TX Practitioner - Occupational Therapist in Private Practice 7416288691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

3033 Acme Brick PLZ
Fort Worth, TX 76109-4227
Phone (817) 484-4447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8076NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince Jan 18, 2024 Accepting new patients
Wheelchair Clinic Inc Occupational Therapist CurrentSince May 1, 2021 Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

4557 S Western St
Ste B4
Amarillo, TX 79109
Phone (801) 440-5592

2021 E Village Green Cir
Ste C
Draper, UT 84020
Phone (801) 440-5592

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1619217346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 LAVA ROCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761797379",
            "telephone_number": "817-542-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 LAVA ROCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761797379",
            "telephone_number": "817-542-9418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Valencia Ct Unit 205",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284127079",
            "country_code": "US",
            "telephone_number": "843-813-0868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINSON",
        "first_name": "KELSEY",
        "middle_name": "CARN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-16",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8076",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kelseypinson14@gmail.com",
            "affiliation": "N",
            "address_1": "5401 Lava Rock Dr",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761797379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.