Kelsea Rodriguez, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

1601 Central Ave W
Wiggins, MS 39577-2401

Phone

(601) 716-3196

NPI assigned

Aug 30, 2023

Last updated

Aug 30, 2023By the provider in NPPES

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

Other names 1

• Kelsea Kasavage Former name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Physical Therapy Clinic IncGroup PAC ID 6103167184, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Southern Physical Therapy Clinic, Inc.

  • Physical Therapy Clinic/Center
  • Picayune, MS
  • NPI 1801370929

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1699550228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20057 BALATA DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395035459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CENTRAL AVE W",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395772401",
            "telephone_number": "601-716-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KELSEA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEA",
            "last_name": "KASAVAGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aesha Rahman, M.D.
• Glynnis D Randall, F.N.P.
• Misty N Ratliff, DC
• Bridget Ray, PHARM D
• Restored Joy Psychiatric Services LLC
• James Jason Rogers, NP
• Kristie Rushing, FNP-C
• Safeway Transportation Service LLC
• Kendra Iesha Samuel, FNP
• Sable M Sanders, PTA

• Occupational Therapist in Wiggins, MS
• Providers in Wiggins, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.