Kelly Lee Taylor, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32002094A Issued in IN

Practice address

2012 Ironwood Cir
Suite 230
South Bend, IN 46635-1888

Phone

(574) 387-4049

NPI assigned

Jan 21, 2012

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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.

• Children's Therapy Innovations Inc.

  dba CTI Aging and Rehabilitative Services

  • Intellectual Disabilities Intermediate Care Facility
  • South Bend, IN
  • NPI 1407166192
  NPD (past)

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327104000000",
    "number": "1821369984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 MILBURN BLVD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444629",
            "telephone_number": "574-850-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 IRONWOOD CIR",
            "address_2": "SUITE 230",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351888",
            "telephone_number": "574-387-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-21",
        "last_updated": "2012-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002094A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Taylor
• Cierra Taylor, RBT
• Darren Taylor
• Denise Taylor
• Gabriela L Taylor, PA
• Larry Taylor, R.PH.
• Lauren Taylor, PTA
• Victoria Elizabeth Taylor, M.S. CCC-SLP
• Team MLS Transportation
• Emile Tebulo, MA

• Occupational Therapy Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2012; 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.