Active NPI
Kelsey C McDonald, COTA/L
- Occupational Therapy Assistant
- Longmeadow, MA
National Provider Identifier
1871194035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3953
- Practice address
- 24 Tabor Xing
Longmeadow, MA 01106-1779 - Phone
- (413) 567-7800
- NPI assigned
- Nov 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3953 | MA | Primary |
Addresses
Primary practice location
24 Tabor Xing
Longmeadow, MA 01106-1779
Mailing address
87 Ellsworth Ave
Springfield, MA 01118-2102
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | glenmeadow.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3953 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1871194035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 ELLSWORTH AVE",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011182102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 TABOR XING",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061779",
"telephone_number": "413-567-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "KELSEY",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MA",
"license": "3953",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "glenmeadow.org",
"affiliation": "N",
"address_1": "24 Tabor Xing",
"city": "Longmeadow",
"state": "MA",
"country_code": "US",
"postal_code": "011061779",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.