KELLI COOPER (NPI# 1639361124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639361124 |
| Entity Type | Individual |
| Full Name | KELLI COOPER |
| Credential | OTR/L, PTA |
| Practice Address |
2225 W Southern Ave Mesa AZ 85202-4716 |
| Mailing Address |
1438 E Angeline Ave San Tan Valley AZ 85140-4063 |
| Practice Telephone | 4804124101 |
| Mailing Telephone | 4807036430 |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2018-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225200000X | Physical Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 225X00000X | Occupational Therapist | OTH-006878 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | LICENSE# | 7773A | 01 |
| AZ | LICENSE# | OTH-006878 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1255 W Baseline Rd Ste 140, Mesa, AZ 852025821 | 4808207675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285901348 | Kelli Anne Cooper | Massage Therapist | 6125 N Sunshine St Ste A, Coeur D Alene, ID 83815-8688 | 2011-11-17 |
| 1932389269 | Kelli Hyatt Cooper | Physical Therapist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 | 2007-11-03 |
| Street Address |
2225 W SOUTHERN AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85202-4716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235195470 | Sheila J Zollicoffer-manley | Nurse Practitioner | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2006-04-25 |
| 1477196277 | Banner Occupational Health Arizona LLC | Clinic/Center | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2019-10-24 |
| 1518511674 | Tatyn Moen | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2019-07-27 |
| 1689175747 | Kimberly Hubbard | Physical Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-02-23 |
| 1679073878 | Maria Camacho | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-02-15 |
| 1871093070 | Mary Martha Stefan | Occupational Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-02-15 |
| 1295233245 | Camille Lambert | Physical Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-01-24 |
| 1780192906 | Sara Becker | Physical Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-01-22 |
| 1497130454 | Ariel Danielle Demoret | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2015-07-20 |
| 1831510130 | Brenna Callaway | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2014-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1457843310 | Jay Douglas Baumgardner | Physical Therapist | 1941 W. Guadalupe Rd. Suite 109, Mesa, AZ 85202 | 2018-06-05 |
| 1144746215 | Alyson Fix | Physician Assistant | 1432 S Dobson Rd Ste 304, Mesa, AZ 85202 | 2017-08-20 |
| 1194108852 | Robert Dale Labrum | Counselor | 1255 W Baseline Rd Ste B-258, Mesa, AZ 85202 | 2015-06-30 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1316356207 | Embry Womens Health LLC | Nurse Practitioner | 2204 S Dobson Road, Suite 203, Mesa, AZ 85202 | 2014-08-05 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1487903373 | Jodi Lynn Mealer | Pharmacist | 1951 W. Baseline Rd., Mesa, AZ 85202 | 2012-09-06 |
| Find all providers in zip 85202 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346856044 | Jayne Louise Lancaster-fisher | Occupational Therapist | 1105 N Delmar, Mesa, AZ 85203-5003 | 2020-09-17 |
| 1467079277 | Tessa Marie Burt | Occupational Therapist | 5850 E Harmony Ave, Mesa, AZ 85206-5532 | 2020-06-26 |
| 1932733458 | Allisynn Marie Powell | Occupational Therapist | 9050 E Brown Rd, Mesa, AZ 85207-4356 | 2020-02-24 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1518515568 | Sarah May Gapuz Bautista | Occupational Therapist | 10044 E Osage Ave, Mesa, AZ 85212-2357 | 2019-09-03 |
| 1164075636 | Kelsey Morgan Smith | Occupational Therapist | 1059 W Laguna Azul Ave, Mesa, AZ 85210-7125 | 2019-07-23 |
| 1629633367 | Accelerated Rehabilitation Centers of Phoenix LLC | Occupational Therapist | 425 N Stapley Dr Ste 105, Mesa, AZ 85203-7281 | 2019-05-08 |
| 1770061269 | Kelly Davies | Occupational Therapist | 737 W Guadalupe Rd Ste 111, Mesa, AZ 85210-7716 | 2018-08-06 |
| 1598241796 | Carson Lauf | Occupational Therapist | 7434 E Forge Ave, Mesa, AZ 85208-2753 | 2018-07-11 |
| 1386144772 | Jane Ann Aitken | Occupational Therapist | 2225 W Southern Ave Bldg 1300, Mesa, AZ 85202-4716 | 2018-02-13 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.