Individual provider Active NPI

Kelli Morelock, OT

  • Occupational Therapist
  • Kingston, TN
National Provider Identifier
1902280464
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4330 Issued in TN
Practice address
187 Gallaher Rd
Kingston, TN 37763-4721
Phone
(865) 376-4620
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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 4330 TN Primary

Addresses

Primary practice location

187 Gallaher Rd
Kingston, TN 37763-4721

Mailing address

187 Gallaher Rd
Kingston, TN 37763-4721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220329000176 TN Practitioner - Occupational Therapist in Private Practice 1456746536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Mar 1, 2022 Accepting new patients
Jane K Bryant Past Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 2

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1902280464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 GALLAHER RD",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377634721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 GALLAHER RD",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377634721",
            "telephone_number": "865-376-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELOCK",
        "first_name": "KELLI",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "4330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.