Active NPI
Kellie Denise Mitchell, COTA/L
- Occupational Therapy Assistant
- Marana, AZ
National Provider Identifier
1942448287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1726
- Practice address
- 16900 W Calle Carmela
Marana, AZ 85653-9215 - Phone
- (520) 682-6153
- NPI assigned
- Jan 23, 2009
- 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 Therapy Assistant | 224Z00000X | 1726 | AZ | Primary |
Addresses
Primary practice location
16900 W Calle Carmela
Marana, AZ 85653-9215
Mailing address
16900 W Calle Carmela
Marana, AZ 85653-9215
Phone (520) 682-6153
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 |
|---|---|---|---|
| 1726 | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1942448287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16900 W CALLE CARMELA",
"city": "MARANA",
"state": "AZ",
"postal_code": "856539215",
"telephone_number": "520-682-6153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16900 W CALLE CARMELA",
"city": "MARANA",
"state": "AZ",
"postal_code": "856539215",
"telephone_number": "520-682-6153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "KELLIE",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-23",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "1726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marana, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.