Patrick Kelly, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32001291A Issued in IN

Practice address

52565 Sr 933
South Bend, IN 46637

Phone

(574) 247-7044

NPI assigned

Jul 1, 2015

Sex

Male

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

State licenses

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1831572478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 OAKDALE DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142847",
            "telephone_number": "574-323-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52565 SR 933",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46637",
            "telephone_number": "574-247-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICK",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001291A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samara Kelley
• Rebecca Kathleen Kelln, PA-C
• Jennifer Marie Kelly
• Lisa B Kelly, LCSW
• Michael Kelly, R.PH
• Starr E Kelly, O.T.
• Kathleen Kelsey, LCSW
• Brian Kemp
• Sydney Kempf
• Cailin Grace Kennedy, OTR/L

• 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 Jul 1, 2015; 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.