Active NPI
Kelsey King, MOT, OTR/L
- Occupational Therapist
- Detroit, MI
National Provider Identifier
1932609450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201009938
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Feb 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | 5201009938 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
4240 Cass Ave Apt 201
Detroit, MI 48201-1970
Phone (248) 885-6048
Other practice location 1
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1000
Other practice location 2
36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5201009938 | Other | MI | MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kking488094@direct.hfhs.org | ||
| Direct Messaging Address | kking488094@direct.hfhs.org | ||
| Direct Messaging Address | kking488094@direct.hfhs.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 |
|---|---|---|---|
| 5201009938 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1932609450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4240 CASS AVE APT 201",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011970",
"telephone_number": "248-885-6048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-2600"
}
],
"practiceLocations": [
{
"address_1": "468 Cadieux Rd",
"address_purpose": "LOCATION",
"city": "Grosse Pointe",
"state": "MI",
"postal_code": "482301507",
"country_code": "US",
"telephone_number": "313-473-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "36475 Five Mile Rd",
"address_purpose": "LOCATION",
"city": "Livonia",
"state": "MI",
"postal_code": "481541971",
"country_code": "US",
"telephone_number": "734-655-4800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KING",
"first_name": "KELSEY",
"credential": "MOT, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-21",
"last_updated": "2021-03-18",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201009938",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
"identifier": "5201009938",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kking488094@direct.hfhs.org",
"affiliation": "N",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022608",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kking488094@direct.hfhs.org",
"affiliation": "N",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022608",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kking488094@direct.hfhs.org",
"affiliation": "N",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.