KELLY BLACK OTR/L
NPI 1942550405
Occupational Therapist in Fayetteville, NC

Active since September 12, 2012
4101 RAEFORD RD, FAYETTEVILLE, NC 28304(910) 488-2120 Get Directions Write a Review

NPPES record last updated: September 17, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 17, 2020, Aug 26, 2019 (2 updates tracked since 2019).

About Kelly Black Otr/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY BLACK OTR/L (NPI 1942550405) is an individual occupational therapist in Fayetteville, North Carolina, licensed in North Carolina (11328) and active in the NPI registry since September 2012. She maintains a secondary practice location in Hines.

NPPES Registry Identity

NPI1942550405
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameKELLY BLACKCredential: OTR/L
Location Address4101 RAEFORD RDFayetteville, NC 28304-4114
Mailing Address1041 Parkers Ridge DrFuquay Varina, NC 27526-5892
Sole ProprietorNo
Enumeration DateSeptember 12, 2012
Last NPPES UpdateSeptember 17, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2020
NPI 1942550405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Licenses Licensed in NC · 11328 Licensed in IL · 056.009759
Definition
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.
4101 RAEFORD RD, Fayetteville, NC 28304

Secondary Practice Location 1

Location 15000 S 5th AveHines, IL 60141-3030 · Phone (708) 202-8387 ext. 22285

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
4101 RAEFORD RD
FAYETTEVILLE, NC 28304
Physical Therapy Assistant
4101 RAEFORD RD
FAYETTEVILLE, NC 28304
Physical Therapist (Orthopedic)
4101 RAEFORD RD
FAYETTEVILLE, NC 28304

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Black's NPI number?

The NPI number for Kelly Black is 1942550405. It was assigned to this individual provider in the NPPES registry on September 12, 2012.

Where is Kelly Black located?

Kelly Black practices at 4101 Raeford Rd, Fayetteville, NC 28304. The listed phone number is (910) 488-2120.

What is Kelly Black's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

When was this NPI record last updated?

The NPPES record for Kelly Black was last updated on September 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.