KETRIC NEDELEA (NPI# 1114574746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114574746 |
| Entity Type | Individual |
| Full Name | KETRIC NEDELEA |
| Credential | COTA/L |
| Practice Address |
204 Shady Pines Ct Fountain Inn SC 29644-9785 |
| Mailing Address |
Po Box 1312 Fountain Inn SC 29644-1054 |
| Practice Telephone | 8644089509 |
| Practice Fax Number | 8643359036 |
| Mailing Telephone | 8644089509 |
| Mailing Fax Number | 8643359036 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 3452 | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
204 SHADY PINES CT |
| City | FOUNTAIN INN |
| State | SC |
| Zip Code | 29644-9785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659610558 | Nancy Wolla Gardner | Occupational Therapist | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2013-02-12 |
| 1912505447 | Sarah Rivard | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-10-16 |
| 1184221947 | Austin Waldrop | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-10-05 |
| 1528665619 | Lindsay G Kennedy | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-10-02 |
| 1215552757 | Kimberly Johnson | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-06-10 |
| 1013531912 | Jacquelyn M Knox | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-06-05 |
| 1912520255 | Alyssa Speake | Occupational Therapist | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-05-21 |
| 1104450964 | Gretchen Wirick | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-03-02 |
| 1922643352 | Selen Aslaner | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2019-11-08 |
| 1962046573 | Jocelyn Ventrello | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2019-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669838991 | Palms Dentistry 225, LLC | Dentist | 208 Harrison Bridge Road, Fountain Inn, SC 29644 | 2015-12-31 |
| 1902155641 | Leah M Mauritz | Pharmacist | 203 N. Main St., Fountain Inn, SC 29644 | 2012-09-07 |
| 1164791778 | Lyfe Intervention Services | Community/Behavioral Health | 401 Putman Street, Fountain Inn, SC 29644 | 2011-12-28 |
| 1629119318 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 810 Dunklin Bridge Road, Fountain Inn, SC 29644 | 2007-02-08 |
| 1841331717 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 810 Dunklin Bridge Road, Fountain Inn, SC 29644 | 2007-02-12 |
| 1912300971 | Grouphab | Clinic/Center | 30 Howard Creek Dr, Fountain Inn, SC 29644-1318 | 2014-10-06 |
| 1235653031 | Fountain Inn Dental, LLC | Dentist | 1125 N Main St, Fountain Inn, SC 29644-1322 | 2017-08-02 |
| 1457950875 | 360 Durable Medical Supplies & Equipment | Durable Medical Equipment & Medical Supplies | 1314 N Main St Ste D, Fountain Inn, SC 29644-1332 | 2020-10-19 |
| 1790210839 | Mukta LLC | Pharmacy | 1103 N Main St Ste E, Fountain Inn, SC 29644-1336 | 2017-04-26 |
| 1457854564 | Tamera Burton Wilson | Specialist | 123 Village Vista Dr, Fountain Inn, SC 29644-1347 | 2018-03-15 |
| Find all providers in zip 29644 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist 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 therapy assistants 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, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669557880 | Jeffery Brown | Occupational Therapy Assistant | 709 Quillen Ave, Fountain Inn, SC 29644-9444 | 2006-10-26 |
| 1912505447 | Sarah Rivard | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-10-16 |
| 1184221947 | Austin Waldrop | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-10-05 |
| 1528665619 | Lindsay G Kennedy | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-10-02 |
| 1215552757 | Kimberly Johnson | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-06-10 |
| 1013531912 | Jacquelyn M Knox | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-06-05 |
| 1104450964 | Gretchen Wirick | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2020-03-02 |
| 1922643352 | Selen Aslaner | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2019-11-08 |
| 1962046573 | Jocelyn Ventrello | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2019-11-06 |
| 1558918185 | Adam Higgs | Occupational Therapy Assistant | 204 Shady Pines Ct, Fountain Inn, SC 29644-9785 | 2019-08-19 |
| Find all providers in FOUNTAIN INN | ||||
| City | FOUNTAIN INN |
| Zip Code | 29644 |
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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.