Kelsey J Peck, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

720 W Main St Ste 102
Battle Ground, WA 98604-4474

Phone

(360) 254-6161

Fax

(360) 449-1146

NPI assigned

Jun 2, 2021

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

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mbody Health LLCGroup PAC ID 7517307275, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelsey.peck.1@29972.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mbody Health, LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1043098965

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1003482787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W MAIN ST STE 102",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044474",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "KELSEY",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parkway Chiropractic
• Penny Marie Pastori, RPH
• Nicolas Aaron Patee, D.P.T.
• Spencer Paterno
• Patient Direct Care
• Amber Elaine Peldo
• Louis I Peng, MD
• Jutta Maria Percifield
• David Donald Peterson, M.A., L.M.H.C.,N.C.C
• Tyrell Pincock, DC

• Physical Therapist in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.