Kali Oliver Shortridge

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA17606 Issued in FL

Practice address

613 Hammonds LN
Brooklyn Park, MD 21225-3351

Phone

(410) 636-3400

NPI assigned

Apr 14, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1811630221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 NW 1ST AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330605206",
            "telephone_number": "954-536-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 HAMMONDS LN",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212253351",
            "telephone_number": "410-636-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 NW 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330605206",
            "country_code": "US",
            "telephone_number": "954-536-3846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER SHORTRIDGE",
        "first_name": "KALI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A03055",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prafullkumar Gordhan Patel, M.D.
• Elizabeth Pettway, MS-CCC-SLP

• Occupational Therapy Assistant in Brooklyn Park, MD
• Providers in Brooklyn Park, MD by specialty
• Occupational Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.