Kathleen Ann Kelleher, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT982 Issued in ME

Practice address

30 Chase Ave
Edmund Ervin Pediatric Center
Waterville, ME 04901-4624

Phone

(207) 872-4390

Fax

(207) 872-4294

NPI assigned

Apr 26, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083834485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 JOHNSON HTS",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014907",
            "telephone_number": "207-873-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHASE AVE",
            "address_2": "EDMUND ERVIN PEDIATRIC CENTER",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014624",
            "telephone_number": "207-872-4390",
            "fax_number": "207-872-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT982",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "ME",
            "license": "PT982",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT982",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Ferris
• Julie Rose Kadnar
• Andrew Kaper
• Lawrence A Kassman, MD
• Sakdhisapol Katanyutanon, M.D.
• Chandler Kelley
• Brandon Kelly
• Monica L. Kelly, LCSW
• Linda Keniston, MD
• Kennebec Eyecare PA

• Physical Therapist in Waterville, ME
• Providers in Waterville, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.