Active NPI
Nancy A Kelly, OTR
- Occupational Therapist
- Midland Park, NJ
National Provider Identifier
1639322860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 008497-1
- Practice address
- 68 Colonial Rd
Midland Park, NJ 07432-1218 - Phone
- (201) 670-4610
- NPI assigned
- Oct 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 008497-1 | NY | Primary |
Addresses
Primary practice location
68 Colonial Rd
Midland Park, NJ 07432-1218
Mailing address
68 Colonial Rd
Midland Park, NJ 07432-1218
Phone (201) 670-4610
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008497-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225411200000",
"number": "1639322860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 COLONIAL RD",
"city": "MIDLAND PARK",
"state": "NJ",
"postal_code": "074321218",
"telephone_number": "201-670-4610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 COLONIAL RD",
"city": "MIDLAND PARK",
"state": "NJ",
"postal_code": "074321218",
"telephone_number": "201-670-4610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "NANCY",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-31",
"last_updated": "2008-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "008497-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.