Basic Information
| Provider Information | |||||||||
| NPI: | 1063432185 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLAMPERT | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OTR L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 EDDY ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029141712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4015339100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 EDDY ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4015339100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT01098 | RI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 2922177 | 01 | RI | EI BLUE CROSS | OTHER | 2092 | 01 | RI | EI NHPRC | OTHER | 413434 | 01 | RI | BLUE CHIP | OTHER | 412296 | 01 | RI | EI BLUE CHIP | OTHER | 6400144 | 01 | RI | EI UHP | OTHER |