Active NPI
Kelly Overstreet, COTA
- Occupational Therapy Assistant
- Gallatin, TN
National Provider Identifier
1962761114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 151
- Practice address
- 695 E Main St
Gallatin, TN 37066-2472 - Phone
- (423) 622-1551
- Fax
- (423) 622-1556
- NPI assigned
- May 9, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 151 | TN | Primary |
Addresses
Primary practice location
695 E Main St
Gallatin, TN 37066-2472
Mailing address
695 E Main St
Gallatin, TN 37066-2472
Phone (423) 622-1551
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 |
|---|---|---|---|
| 151 | TN | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336521600000",
"number": "1962761114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 E MAIN ST",
"city": "GALLATIN",
"state": "TN",
"postal_code": "370662472",
"telephone_number": "423-622-1551",
"fax_number": "423-622-1556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 E MAIN ST",
"city": "GALLATIN",
"state": "TN",
"postal_code": "370662472",
"telephone_number": "423-622-1551",
"fax_number": "423-622-1556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERSTREET",
"first_name": "KELLY",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-09",
"last_updated": "2012-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TN",
"license": "151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallatin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.