Kelly Lynn Mahoney, MPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT21213 Issued in CA

Practice address

2108 Huntington LN # a
Redondo Beach, CA 90278-4309

Phone

(310) 372-3292

NPI assigned

Mar 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pearl Chiropractic Inc

  • Chiropractor
  • Long Beach, CA
  • NPI 1871105031
  NPD (past)
• Women'S Advantage Physical Therapy Inc

  • Orthopedic Physical Therapist
  • Torrance, CA
  • NPI 1396054953
  NPD (past)

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1104124544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 HUNTINGTON LN # A",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784309",
            "telephone_number": "310-372-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 HUNTINGTON LN # A",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784309",
            "telephone_number": "310-372-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT21213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT21213",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peggy Gray Magnusson, D.P.M.
• Lea Magsayo, LMT
• Mah Health Services LLC
• Roohbakhsh Maher, DPM
• Sanna Mahmood, MD
• Amber Malanowski, ND
• Natally Maldonado Badillo
• Eddie Modesto Maldonado, BS.,CMP
• Lori Kay Malinbaum, DDS
• Nancy Maloney, LMFT

• Orthopedic Physical Therapist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.