Kelly Hannah, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

10369 Issued in FL

Practice address

1655 SE Walton Rd
Port St Lucie, FL 34952-7657

Phone

(772) 337-1333

NPI assigned

Apr 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sobe Innovative Rehabilitation PLLCGroup PAC ID 4789994336, 178 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sobe Innovative Rehabilitation PLLC

  • Physical Therapist
  • Miami, FL
  • NPI 1164800595
  Medicare reassignment Care Compare group
• Physiocare Inc

  • Physical Therapy Clinic/Center
  • Jupiter, FL
  • NPI 1396753026
  NPD (past)

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1649967456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SW NIKOMA ST",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902739",
            "telephone_number": "352-219-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 SE WALTON RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527657",
            "telephone_number": "772-337-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "KELLY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "10369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Allen Hancock
• Walleska Handal
• Hands of St. Lucie County
• Hands on Performance LLC
• Beverly Sue Hanna
• Kristen Hanrahan, DO
• Megan Arellano Hanvivatpong, DDS
• Liam Harb, DDS
• Hardcore Support Services, Inc.
• Shakeya Lashae Hargrove, CRDH

• Occupational Therapist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.