Individual provider Active NPI

Keniel O. McLennon, OTR/L

  • Occupational Therapist
  • Shelton, CT
National Provider Identifier
1710252218
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003885 Issued in CT
Practice address
45 Maltby St
Shelton, CT 06484-3328
Phone
(203) 924-4671
NPI assigned
Mar 15, 2012
Last updated
Mar 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 003885 CT Primary

Addresses

Primary practice location

45 Maltby St
Shelton, CT 06484-3328

Mailing address

45 Maltby St
Shelton, CT 06484-3328

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003885CTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1710252218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MALTBY ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MALTBY ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843328",
            "telephone_number": "203-924-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENNON",
        "first_name": "KENIEL",
        "middle_name": "O.",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "003885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.