Active NPI
Kellee Bruce Lavalley, MPT
- Pediatric Physical Therapist
- Plattsburgh, NY
National Provider Identifier
1104061308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 23082
- Practice address
- 185 Margaret Street
Suite 1000
Plattsburgh, NY 12985 - Phone
- (518) 561-6361
- Fax
- (518) 561-6367
- NPI assigned
- Dec 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 23082 | NY | Primary |
Addresses
Primary practice location
185 Margaret Street
Suite 1000
Plattsburgh, NY 12985
Mailing address
185 Margaret St.
Suite 1000
Plattsburgh, NY 12985
Phone (518) 561-6361
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23082 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| 023082 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1104061308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 MARGARET ST.",
"address_2": "SUITE 1000",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "12985",
"telephone_number": "518-561-6361",
"fax_number": "518-561-6367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 MARGARET STREET",
"address_2": "SUITE 1000",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "12985",
"telephone_number": "518-561-6361",
"fax_number": "518-561-6367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVALLEY",
"first_name": "KELLEE",
"middle_name": "BRUCE",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-03",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NY",
"license": "23082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plattsburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.