Individual provider Active NPI

Kelly Kittrell-Davis, OTR, CHT

  • Hand Occupational Therapist
  • Crossville, TN
National Provider Identifier
1730282864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
283 Issued in TN
Practice address
25 Maple Grove Dr Ste 103
Crossville, TN 38555-7626
Phone
(931) 456-5488
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 283 TN Primary

Addresses

Primary practice location

25 Maple Grove Dr Ste 103
Crossville, TN 38555-7626

Mailing address

PO Box 474
Wartburg, TN 37887-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220321001299 TN Practitioner - Occupational Therapist in Private Practice 4284029703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
283TNMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Dec 15, 2021 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Dec 15, 2021 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

1501 12th Ave S
Nashville, TN 37203
Phone (615) 269-3461

443 S Illinois Ave
Oak Ridge, TN 37830
Phone (865) 813-6450

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730282864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "WARTBURG",
            "state": "TN",
            "postal_code": "378870474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MAPLE GROVE DR STE 103",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385557626",
            "telephone_number": "931-456-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTRELL-DAVIS",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "OTR, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "TN",
            "license": "283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.