Lars Edward Kellow, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5879 Issued in OR

Practice address

11850 SW Allen Blvd
Beaverton, OR 97005-4805

Phone

(503) 646-7164

NPI assigned

May 28, 2009

Last updated

May 28, 2009By the provider in NPPES

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 OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benchmark Physical Therapy of Oregon LLCGroup PAC ID 0143510602, 124 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Wilsonville, OR
  • NPI 1407365331
  NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1063647444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9316 SW CORAL ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236663",
            "telephone_number": "541-760-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 SW ALLEN BLVD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054805",
            "telephone_number": "503-646-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOW",
        "first_name": "LARS",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Keliiheleua, N.D.
• Bridget Keller
• David Larsen Keller, DMD
• Stephanie Michelle Keller
• Cathryn Grace Kellett
• Madeleine Kelly
• Ally Kemp
• Kenneth Edward Kemp, LMHCA
• Benjamin Kennedy Cadd
• Michela Kenning, O.D.

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.