Individual provider Active NPI

Kelsey Ann Williams

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1912482514
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
119128 Issued in TX
Practice address
3201 Cherry Ridge St Ste C323
San Antonio, TX 78230-4831
Phone
(210) 349-1415
Fax
(210) 349-1417
NPI assigned
Sep 28, 2018
Last updated
Sep 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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 119128 TX Primary

Addresses

Primary practice location

3201 Cherry Ridge St Ste C323
San Antonio, TX 78230-4831

Mailing address

3201 Cherry Ridge St Ste C323
San Antonio, TX 78230-4831
Phone (210) 349-1415

Other identifiers 1

IdentifierTypeStateIssuer
742741474OtherTAX ID

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
119128TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Learning, LP PastSince Feb 17, 2016 Accepting new patients
Grow Strong Together Occupational Therapist Past Accepting new patients

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, 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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1912482514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 CHERRY RIDGE ST STE C323",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304831",
            "telephone_number": "210-349-1415",
            "fax_number": "210-349-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 CHERRY RIDGE ST STE C323",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304831",
            "telephone_number": "210-349-1415",
            "fax_number": "210-349-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "119128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "742741474",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.