Kellie S Doolittle, LOTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

200095 Issued in LA

Practice address

980 Montgomery St
Mandeville, LA 70448-5519

Phone

(434) 987-3396

NPI assigned

Jun 29, 2007

Last updated

Aug 9, 2013By the provider in NPPES

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 2

Other names 1

• Kellie L Schulingkamp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1689871824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 MONTGOMERY ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704485519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 MONTGOMERY ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704485519",
            "telephone_number": "434-987-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLITTLE",
        "first_name": "KELLIE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LOTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "200095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID ADVANCE HAND SPECIALIST DBA MCMILLIAN CORPORTAION",
            "identifier": "20-2541563",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXPAYER IDENITIFICATION NUMBER MCMILLIAN CORPORATION",
            "identifier": "27-1727146",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "SCHULINGKAMP",
            "middle_name": "L",
            "credential": "LOTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.