Individual provider Active NPI

Kailey E Connolly, PT, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1093113375
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P60462617 Issued in WA
Practice address
2560 32ND Ave W
Seattle, WA 98199-3220
Phone
(206) 660-1218
NPI assigned
Dec 18, 2014
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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 P60462617 WA Primary

Addresses

Primary practice location

2560 32ND Ave W
Seattle, WA 98199-3220

Mailing address

4316 36TH Ave W Apt a
Seattle, WA 98199-1157
Phone (206) 406-9078

Other practice location 1

4455 148th Ave NE
Bellevue, WA 98007-3120
Phone (425) 861-6255

Other practice location 2

4316 36th Ave W Apt A
Seattle, WA 98199-1157
Phone (206) 406-9078

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P60462617WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Physical Therapy Co CurrentSince May 31, 2020 Accepting new patients
Fluid Motion Physical Therapy and Pilates PLLC CurrentSince May 31, 2020 Accepting new patients

Locations

2560 32nd Ave W
Seattle, WA 98199
Phone (206) 660-1218

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1093113375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 36TH AVE W APT A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981991157",
            "telephone_number": "206-406-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 32ND AVE W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993220",
            "telephone_number": "206-660-1218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 148th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073120",
            "country_code": "US",
            "telephone_number": "425-861-6255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4316 36th Ave W Apt A",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981991157",
            "country_code": "US",
            "telephone_number": "206-406-9078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KAILEY",
        "middle_name": "E",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-18",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "P60462617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.