Individual provider Active NPI

Kelly M Green, OTR/L

  • Occupational Therapist
  • Georgetown, KY
National Provider Identifier
1912215229
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
135581 Issued in KY
Practice address
101 Windsor Path
Georgetown, KY 40324-9617
Phone
(859) 263-5140
Fax
(859) 263-5141
NPI assigned
Sep 21, 2010
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X R4593 KY
Occupational Therapist 225X00000X 135581 KY Primary

Addresses

Primary practice location

101 Windsor Path
Georgetown, KY 40324-9617

Mailing address

3480 Yorkshire Medical Park
Lexington, KY 40509-1886
Phone (859) 263-5140

Other practice location 1

1760 Harrodsburg Rd
Lexington, KY 40504-3602
Phone (859) 263-5140

Other practice location 2

850 Hail Knob Rd Ste B
Somerset, KY 42503-3418
Phone (859) 263-5140

Other practice location 3

111 Cynthia Dr Ste 139
Nicholasville, KY 40356-8062
Phone (859) 263-5140

Other practice location 4

145 Newcomb Ave
Mount Vernon, KY 40456-2728
Phone (859) 263-5140

Other practice location 5

3480 Yorkshire Medical Park
Lexington, KY 40509-1886
Phone (859) 263-5140

Other practice location 6

3401 Yorkshire Medical Park
Lexington, KY 40509-2513
Phone (859) 263-5140

Other practice location 7

1868 Plaudit Pl
Lexington, KY 40509-2429
Phone (859) 263-5140

Other practice location 8

195 Commercial Dr
London, KY 40744-8234
Phone (859) 263-5140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110204000652 KY Practitioner - Occupational Therapist in Private Practice 9739369943 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135581KYMDOccupational Therapist
R4593KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Orthopaedics PSC Occupational Therapist CurrentSince Jan 4, 2021 Accepting new patients
Bluegrass Orthopaedics PSC Occupational Therapist Past Accepting new patients
Kentucky Hand and Physical Therapy BC LLC Past Accepting new patients

Locations

101 Windsor Path
Georgetown, KY 40324
Phone (502) 868-6106

151 N Eagle Creek Dr
Ste 400
Lexington, KY 40509
Phone (859) 264-8866

1760 Harrodsburg Rd
Lexington, KY 40504

1868 Plaudit Pl
Lexington, KY 40509
Phone (859) 543-0002

3401 Yorkshire Medical Park
Lexington, KY 40509

3480 Yorkshire Medical Park
Lexington, KY 40509
Phone (859) 303-8803

195 Commercial Dr
London, KY 40744

1350 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 462-8016

145 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-2195

111 Cynthia Dr
Ste 139
Nicholasville, KY 40356

789 Eastern Byp
Ste 4
Richmond, KY 40475
Phone (859) 625-5564

850 Hail Knob Rd
#B
Somerset, KY 42503
Phone (270) 318-3399

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61440

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1912215229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WINDSOR PATH",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249617",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1760 Harrodsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043602",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Hail Knob Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425033418",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Cynthia Dr Ste 139",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403568062",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 Newcomb Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "KY",
            "postal_code": "404562728",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3480 Yorkshire Medical Park",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405091886",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Yorkshire Medical Park",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092513",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1868 Plaudit Pl",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092429",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 Commercial Dr",
            "address_purpose": "LOCATION",
            "city": "London",
            "state": "KY",
            "postal_code": "407448234",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R4593",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "135581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.