Individual provider Active NPI

Judith Kelly Springs, COTA

  • Occupational Therapy Assistant
  • Springfield, TN
National Provider Identifier
1851742274
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2288 Issued in TN
Practice address
3131 Tom Austin Hwy
Springfield, TN 37172-4801
Phone
(615) 382-7979
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2288 TN Primary
Occupational Therapy Assistant 224Z00000X OTA3119 CA
Occupational Therapy Assistant 224Z00000X OTA13186 FL

Addresses

Primary practice location

3131 Tom Austin Hwy
Springfield, TN 37172-4801

Mailing address

130 Hillview Dr
La Vergne, TN 37086-3105
Phone (615) 294-5970

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

LicenseStateTypeSpecialty
2288TNMDOptometrist
OTA3119CAMDOccupational Therapy Assistant
OTA13186FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1851742274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HILLVIEW DR",
            "city": "LA VERGNE",
            "state": "TN",
            "postal_code": "370863105",
            "telephone_number": "615-294-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 TOM AUSTIN HWY",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724801",
            "telephone_number": "615-382-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRINGS",
        "first_name": "JUDITH",
        "middle_name": "KELLY",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "2288",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA3119",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA13186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.