Kellan Robert Barry

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1391899 Issued in TX

Practice address

12500 Judson Rd # 201
Live Oak, TX 78233-4101

Phone

(210) 699-8326

NPI assigned

May 15, 2024

Sex

Male

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 TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Texas Physical Therapy Specialists, Inc.

  • Physical Therapist
  • New Braunfels, TX
  • NPI 1689781338
  Medicare reassignment Care Compare group NPD
• Sports Medicine Associates of San Antonio, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Antonio, TX
  • NPI 1861549503

  Physical Therapist, TX

  Medicare reassignment NPD
• Sports Medicine Associates of San Antonio, PA

  • Orthopaedic Surgery Physician
  • San Antonio, TX
  • NPI 1568280808
  NPD
• Texas Physical Therapy Specialists

  • Durable Medical Equipment & Medical Supplies
  • Austin, TX
  • NPI 1568049484
  NPD
• Sports Medicine Associates of San Antonio, PA

  • Physical Therapist
  • San Antonio, TX
  • NPI 1609124312
  NPD (past)

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Physical Therapy Specialists, Inc 238 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1013766633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BURR OAK ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781557433",
            "telephone_number": "830-304-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 JUDSON RD # 201",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334101",
            "telephone_number": "210-699-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "KELLAN",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1391899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Willow Baker, DNP
• Eric Matthew Banik, PT, DPT
• Kenae Banks
• Caitlin Sage Barboza, M.S. CCC-SLP
• Evan Barnes
• Wendall Bauman, M.D.
• Irina Bazan
• BBR Anesthesia
• Lauren Maritza Bell, RBT
• Jeremy Benjamin

• All providers in Live Oak, TX
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.