Individual provider Active NPI

Kelsie Long

  • Occupational Therapist
  • Kalamazoo, MI
National Provider Identifier
1740919547
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201012759 Issued in MI
Practice address
601 John St Kalamazoo
Kalamazoo, MI 49007
Phone
(269) 341-7654
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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 5201012759 MI Primary

Addresses

Primary practice location

601 John St Kalamazoo
Kalamazoo, MI 49007

Mailing address

Bronson Healthcare Group, 601 John St
Kalamazoo, MI 49007

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
5201012759MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1740919547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BRONSON HEALTHCARE GROUP, 601 JOHN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST KALAMAZOO",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007",
            "telephone_number": "269-341-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KELSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201012759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.