Mallory Osborne Goettl, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

260897 Issued in KY

Practice address

400 Farris Parks Blvd
Richmond, KY 40475-7650

Phone

(859) 353-3666

NPI assigned

Nov 21, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1760028948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FARRIS PARKS BLVD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404757650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FARRIS PARKS BLVD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404757650",
            "telephone_number": "859-353-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTL",
        "first_name": "MALLORY",
        "middle_name": "OSBORNE",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "260897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayla Makell Gibson
• Zahrea Chantel Gill
• John Paul Gillespie, MD
• Cameron Gilliam
• Vishal Goel, MD
• Shana Leigh Goggins, MA, LPCA
• Rebecca Goines, LPCC
• Golden Home Care LLC
• Gail Goldstein, CCC-SLP
• Donna Joyce Goodman, APRN

• Occupational Therapist in Richmond, KY
• Providers in Richmond, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.