Individual provider Active NPI

Kaylee Nelson, PT, DPT

  • Physical Therapist
  • Redmond, WA
National Provider Identifier
1053789925
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60551651 Issued in WA
Practice address
22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033
Phone
(425) 836-1034
Fax
(425) 836-1037
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 PT60551651 WA Primary

Addresses

Primary practice location

22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033

Mailing address

22500 NE Marketplace Dr Ste 204
Redmond, WA 98053-2033
Phone (425) 836-1034

Other practice location 1

14110 Main St NE Ste A
Duvall, WA 98019-8475
Phone (425) 429-7278

Other practice location 2

13930 NE 178th Pl Ste 112
Woodinville, WA 98072-3571
Phone (425) 939-2194

Other identifiers 2

IdentifierTypeStateIssuer
0345754OtherWAL & I
0348777OtherWAL & I

Other names 1

  • Kaylee Brantley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151109000661 WA Practitioner - Physical Therapist in Private Practice 5890005540 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Washington Physical Therapy LLCGroup PAC ID 3476679812, 54 clinicians

Practice addresses (Care Compare)

209 Kirkland Ave
Kirkland, WA 98033-6503
Phone (425) 629-3502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60551651WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Sep 14, 2015 Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 14, 2020 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC Physical Therapist CurrentSince Sep 14, 2015 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Sep 14, 2015 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Sep 14, 2015 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Sep 14, 2015 Accepting new patients
Lake Washington Physical Therapy LLC Physical Therapist CurrentSince Nov 11, 2019 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Sep 14, 2015 Accepting new patients

Locations

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

13555 SE 36th St
Ste 100
Bellevue, WA 98006

14110 Main St NE
Ste A
Duvall, WA 98019
Phone (425) 429-7278

2000 Hewitt Ave
Ste 115
Everett, WA 98201
Phone (425) 252-3908

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

6704 NE 181st St
Ste 101
Kenmore, WA 98028
Phone (425) 246-9799

209 Kirkland Ave
Kirkland, WA 98033
Phone (425) 629-3502

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

22500 NE Marketplace Dr
Ste 204
Redmond, WA 98053
Phone (425) 836-1034

1830 Bickford Ave
Ste 209
Snohomish, WA 98290
Phone (360) 568-7774

13930 NE 178th Pl
Ste 112
Woodinville, WA 98072
Phone (425) 939-2194

Organizations & group practices 8

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1053789925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22500 NE MARKETPLACE DR STE 204",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980532033",
            "telephone_number": "425-836-1034",
            "fax_number": "425-836-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22500 NE MARKETPLACE DR",
            "address_2": "SUITE 204",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980532033",
            "telephone_number": "425-836-1034",
            "fax_number": "425-836-1037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14110 Main St NE Ste A",
            "address_purpose": "LOCATION",
            "city": "Duvall",
            "state": "WA",
            "postal_code": "980198475",
            "country_code": "US",
            "telephone_number": "425-429-7278",
            "fax_number": "425-341-9035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13930 NE 178th Pl Ste 112",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980723571",
            "country_code": "US",
            "telephone_number": "425-939-2194",
            "fax_number": "425-318-1102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KAYLEE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60551651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0345754",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0348777",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEE",
            "last_name": "BRANTLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.