Individual provider Active NPI

Katherine Bussell Deeley, OTRL

  • Occupational Therapist
  • Boston, MA
National Provider Identifier
1962610188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5495 Issued in MA
Practice address
736 Cambridge St
Boston, MA 02135-2907
Phone
(617) 789-3258
NPI assigned
May 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5495 MA Primary

Addresses

Primary practice location

736 Cambridge St
Boston, MA 02135-2907

Mailing address

61 Kenney St
Needham, MA 02492-4447
Phone (781) 444-5996

Other names 1

  • Miss Katherine Elizabeth Bussell Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5495MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Physical Therapy, Inc. Occupational Therapist CurrentSince Dec 19, 2024 Accepting new patients
Joint Ventures Physical Therapy, Inc. Occupational Therapist CurrentSince Dec 19, 2024 Accepting new patients

Locations

204 Worcester St
#200
Wellesley, MA 02481

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": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962610188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 KENNEY ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024924447",
            "telephone_number": "781-444-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEELEY",
        "first_name": "KATHERINE",
        "middle_name": "BUSSELL",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "5495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BUSSELL",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.