Individual provider Active NPI

Kelly Winslow Thielman, OTA/L

  • Occupational Therapy Assistant
  • Greensboro, NC
National Provider Identifier
1962211367
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
7172 Issued in NC
Practice address
5403 Holly Ridge Rd
Greensboro, NC 27455-1520
Phone
(919) 358-0400
NPI assigned
Jan 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X
Occupational Therapy Assistant 224Z00000X 7172 NC Primary

Addresses

Primary practice location

5403 Holly Ridge Rd
Greensboro, NC 27455-1520

Mailing address

5403 Holly Ridge Rd
Greensboro, NC 27455-1520
Phone (919) 358-0400

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

NPI Registry JSON

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

{
    "created_epoch": "1735689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1962211367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 HOLLY RIDGE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274551520",
            "telephone_number": "919-358-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5403 HOLLY RIDGE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274551520",
            "telephone_number": "919-358-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELMAN",
        "first_name": "KELLY",
        "middle_name": "WINSLOW",
        "credential": "OTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-01",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "7172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.