Individual provider Active NPI

Richard R Kelly, OT

  • Occupational Therapist
  • Lewisville, TX
National Provider Identifier
1801960026
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
966 N Garden Ridge
Suite 530
Lewisville, TX 75077
Phone
(972) 420-6605
Fax
(972) 436-2770
NPI assigned
Nov 20, 2006
Last updated
May 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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 NU Primary

Addresses

Primary practice location

966 N Garden Ridge
Suite 530
Lewisville, TX 75077

Mailing address

966 N Garden Ridge
Suite 530
Lewisville, TX 75077
Phone (972) 420-6605

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4603TXMDBehavioral Analyst
104603TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lewisville Therapy Center Inc PastSince Jun 30, 1997 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1801960026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 N GARDEN RIDGE",
            "address_2": "SUITE 530",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75077",
            "telephone_number": "972-420-6605",
            "fax_number": "972-436-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 N GARDEN RIDGE",
            "address_2": "SUITE 530",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75077",
            "telephone_number": "972-420-6605",
            "fax_number": "972-436-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RICHARD",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.