Active NPI
Kimberly Conley, OTRL
- Occupational Therapist
- Bristol, TN
National Provider Identifier
1770610024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT0000003593
- Practice address
- 1 Medical Park Blvd
Bristol, TN 37620-7430 - Phone
- (423) 844-4116
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT0000003593 | TN | Primary |
Addresses
Primary practice location
1 Medical Park Blvd
Bristol, TN 37620-7430
Mailing address
2931 Broad St Apt 113
Bristol, TN 37620-3469
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT0000003593 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770610024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2931 BROAD ST APT 113",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376203469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK BLVD",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376207430",
"telephone_number": "423-844-4116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "KIMBERLY",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "OT0000003593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.