Kerry Anne Nissen, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3641 Issued in SC

Practice address

2049 Rocky Stream Rd
York, SC 29745-6611

Phone

(615) 456-5391

Fax

(888) 770-7861

NPI assigned

Jan 3, 2007

Last updated

Nov 17, 2010By 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

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Collective Therapy Corp.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1396380911

  SC

  Medicare reassignment
• Lifestyle Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Clover, SC
  • NPI 1962687467
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1730236985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2049 ROCKY STREAM RD",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297456611",
            "telephone_number": "615-456-5391",
            "fax_number": "888-770-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2049 ROCKY STREAM RD",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297456611",
            "telephone_number": "615-456-5391",
            "fax_number": "888-770-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSEN",
        "first_name": "KERRY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Jones Myers, RN
• Amy Ann Nedrow, D.C.
• Helene H Neely, RN
• NHC Healthcare/York, LLC
• Crystal S Nichols, RN
• Northland Hearing Center Inc
• Novant Medical Group, Inc. (Novant Health Family Medicine Associates)
• Oliver Eye Associates PA
• William C Oliver, OD
• Orchid Mental Health

• Occupational Therapist in York, SC
• Providers in York, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.