Individual provider Active NPI

Kelly Dawn Barefoot, OTR/L

  • Occupational Therapist
  • California, MD
National Provider Identifier
1710172440
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07067 Issued in MD
Practice address
22593 Three Notch Rd
California, MD 20619-3054
Phone
(301) 862-2505
NPI assigned
Sep 6, 2007
Last updated
Aug 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119003660 VA
Occupational Therapist 225X00000X 07067 MD Primary

Addresses

Primary practice location

22593 Three Notch Rd
California, MD 20619-3054

Mailing address

22593 Three Notch Rd
California, MD 20619-3054
Phone (301) 862-2505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07067MDMDSocial Worker
0119003660VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1710172440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22593 THREE NOTCH RD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193054",
            "telephone_number": "301-862-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22593 THREE NOTCH RD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193054",
            "telephone_number": "301-862-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAREFOOT",
        "first_name": "KELLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119003660",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.