Kelly Cobb Nelson, MS OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT03452 Issued in GA

Practice address

1203 Bombay LN
Roswell, GA 30076-5822

Phone

(770) 851-9553

Fax

(770) 698-4178

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Kelly Elizabeth Cobb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679638977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 CAMDEN WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765822",
            "telephone_number": "770-851-9553",
            "fax_number": "770-698-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KELLY",
        "middle_name": "COBB",
        "name_prefix": "Mrs.",
        "credential": "MS OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT03452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "930130",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "COBB",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "MS OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis Navarro
• Arun Nayyar, DDS
• Obiora Nduka
• Jennifer Nealer, OTD, OTR/L
• Anthony D Nearhood, D.C.
• Sterling Hall Nelson, MS, M.ED
• Shekofe Ashley Nematollahi, PA
• Shyda Nematollahi
• Ayesha Nesbeth-Aguila
• Jennifer Nestor-Cardwell, LPC, ATR

• Pediatric Occupational Therapist in Roswell, GA
• Providers in Roswell, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.