Kelly Ann Roberson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5887 Issued in AZ

Practice address

7654 N 19TH Ave # Qve
Phoenix, AZ 85021-7025

Phone

(602) 771-5300

NPI assigned

Apr 2, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1992334809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6610 E ROSE MARIE LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850546750",
            "telephone_number": "602-989-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7654 N 19TH AVE # QVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217025",
            "telephone_number": "602-771-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "5887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Vincent Robers, M.D.
• Roberson Clinical Services, LLC
• Angela Roberson, LCSW
• Frenita Roberson
• Joseph Charles Roberson, PH.D.
• Robert B Ogesen PC
• Robert Brems MD PC
• Robert E Raffel M D Inc
• Robert G Condra DO PC
• Robert G Saide MD PC

• Occupational Therapy Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Occupational Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.