Individual provider Active NPI

Kathleen Costello, OT

  • Occupational Therapist
  • Providence, RI
National Provider Identifier
1871135822
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT01855 Issued in RI
Practice address
1 Randall SQ Ste 302
Providence, RI 02904-2773
Phone
(401) 793-1829
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT01855 RI Primary

Addresses

Primary practice location

1 Randall SQ Ste 302
Providence, RI 02904-2773

Mailing address

903 Providence PL Apt 146
Providence, RI 02903-7003
Phone (203) 848-0175

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
OT01855RIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Small Steps Therapy LLC Occupational Therapist CurrentSince Oct 27, 2019 Accepting new patients

Locations

1 Randall Sq
Ste 302
Providence, RI 02904
Phone (401) 793-1829

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1871135822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 PROVIDENCE PL APT 146",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029037003",
            "telephone_number": "203-848-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ STE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042773",
            "telephone_number": "401-793-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "KATHLEEN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "RI",
            "license": "OT01855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.