Krystle Lee Concepcion, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12403 Issued in MA

Practice address

9 Needhams Landing Road Apt. 401
Lynn, MA 01905

Phone

(781) 439-3103

NPI assigned

Jan 29, 2014

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

Other names 1

• Krystle Lee Chisholm (Maiden) Former name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Visiting Therapists LLC

  • Physical Therapist
  • Haverhill, MA
  • NPI 1619110897
  Medicare reassignment

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1861815649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NEEDHAMS LANDING ROAD APT. 401",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "01905",
            "telephone_number": "781-439-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NEEDHAMS LANDING ROAD APT. 401",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "01905",
            "telephone_number": "781-439-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "KRYSTLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "CHISHOLM (MAIDEN)",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Commonwealth of Massachusetts
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• Kristen Congelosi
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• Ruth Conklin
• Margaret Elise Connell, NP-C
• Jeniffer Lynne Conner, LCSW

• Occupational Therapist in Lynn, MA
• Providers in Lynn, MA by specialty
• Occupational Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.