Individual provider Active NPI

David M Kelley, DPT

  • Physical Therapist
  • Lanesboro, MA
National Provider Identifier
1053633305
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18524 Issued in MA
Practice address
31 Williamstown Road
Lanesboro, MA 01237
Phone
(413) 442-7007
Fax
(413) 442-7011
NPI assigned
Feb 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18524 MA Primary

Addresses

Primary practice location

31 Williamstown Road
Lanesboro, MA 01237

Mailing address

31 Williamstown Road
Lanesboro, MA 01237
Phone (413) 442-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18524MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greylock Physical Therapy, Inc. Physical Therapist PastSince May 6, 1991 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1053633305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WILLIAMSTOWN ROAD",
            "city": "LANESBORO",
            "state": "MA",
            "postal_code": "01237",
            "telephone_number": "413-442-7007",
            "fax_number": "413-442-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WILLIAMSTOWN ROAD",
            "city": "LANESBORO",
            "state": "MA",
            "postal_code": "01237",
            "telephone_number": "413-442-7007",
            "fax_number": "413-442-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanesboro, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.