Kelsey Bouthilette, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

13480 Issued in MA

Practice address

11 Saint Anthony St
Chicopee, MA 01013-2141

Phone

(413) 315-4205

Fax

(413) 552-3426

NPI assigned

Sep 10, 2021

Last updated

Sep 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Powerback Rehabilitation of Ma, PC

  • Physical Therapist
  • South Hamilton, MA
  • NPI 1194688341
  Medicare reassignment

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1982373122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GLENDALE ST",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010272005",
            "telephone_number": "413-552-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SAINT ANTHONY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010132141",
            "telephone_number": "413-315-4205",
            "fax_number": "413-552-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTHILETTE",
        "first_name": "KELSEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Bordo, MSN, CNP, PMHNP-BC
• Anna Bouchard
• Deborah A Boulanger, LMT
• Mark A Bourcier, DMD
• Sean Bourgeoise, MA
• Luz Bowler, LCSW
• Lisa Marteki Boye, NP
• Stephanie Marie Bradt
• Brain Solutions Lab
• Marcia Branch

• Occupational Therapist in Chicopee, MA
• Providers in Chicopee, MA by specialty
• Occupational Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.