Carol Lee Kelly

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC60159972 Issued in WA

Practice address

1939 SW Troon Ave
Bend, OR 97702

Phone

(503) 468-8757

NPI assigned

May 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1699900464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 SW TROON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023143",
            "telephone_number": "035-468-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 SW TROON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "503-468-8757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 NE Park Plaza Dr",
            "address_2": "Suite 246",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986845808",
            "country_code": "US",
            "telephone_number": "360-696-1070 x741",
            "fax_number": "360-737-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 NE Park Plaza Dr",
            "address_2": "Suite 246",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986845808",
            "country_code": "US",
            "telephone_number": "360-696-1070 x741",
            "fax_number": "360-737-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CAROL",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC60159972",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OR",
            "license": "412866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Christopher Kelley, DO
• Lezlie Neusteter Kellison, LCSW
• Ann Elisabeth Kellogg, D.O.
• Edward Kellogg
• Kelly Belczyk LCSW LLC
• Casie Kelly, LMT
• Chelsea Catherine Kelly, CRM
• Jandi Kelly, MS, PHD
• Jennifer Marie Kelly, DPT
• Kara Lynn Kelly, N.P.

• Occupational Therapy Assistant in Bend, OR
• Providers in Bend, OR by specialty
• Occupational Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.