Individual provider Active NPI

Amber Marie Kelly

  • Pediatric Occupational Therapist
  • Broadlands, VA
National Provider Identifier
1942708391
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
Loudoun County Public Schools
21000 Education CT
Broadlands, VA 20148
Phone
(571) 252-1000
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X
Pediatric Occupational Therapist 225XP0200X VA Primary

Addresses

Primary practice location

Loudoun County Public Schools
21000 Education CT
Broadlands, VA 20148

Mailing address

PO Box 405
Hamilton, VA 20159-0405
Phone (571) 271-8289

Other practice location 1

7001A Loisdale Rd
Springfield, VA 22150-1904
Phone (703) 971-0602

Other practice location 2

3900 Jermantown Rd Ste 250
Fairfax, VA 22030
Phone (571) 271-8289

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun County Public Schools PastSince May 21, 2023 Accepting new patients
Exceptional Childrens Center, LLC Pediatrics PastSince Oct 1, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1942708391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405",
            "city": "HAMILTON",
            "state": "VA",
            "postal_code": "201590405",
            "telephone_number": "571-271-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOUDOUN COUNTY PUBLIC SCHOOLS",
            "address_2": "21000 EDUCATION CT",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "20148",
            "telephone_number": "571-252-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7001A Loisdale Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221501904",
            "country_code": "US",
            "telephone_number": "703-971-0602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 Jermantown Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "22030",
            "country_code": "US",
            "telephone_number": "571-271-8289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broadlands, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.