Individual provider Active NPI

Kendyll Kearney, DPT

  • Physical Therapist
  • Buckeye, AZ
National Provider Identifier
1164248407
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
825 S Watson Rd Ste 106
Buckeye, AZ 85326-3435
Phone
(623) 207-4015
Fax
(623) 471-8746
NPI assigned
Dec 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 Primary

Addresses

Primary practice location

825 S Watson Rd Ste 106
Buckeye, AZ 85326-3435

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

425 Brookline Ave
Boston, MA 02215-5410
Phone (617) 232-4018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241219000640 MA Practitioner - Physical Therapist in Private Practice 9931636636 Reassigns benefits to 1 organization
I20250725001917 AZ Practitioner - Physical Therapist in Private Practice 9931636636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

101 University Dr
Suite A6
Amherst, MA 01002-2385
Phone (413) 336-5703

75 Spring St
Suite 77
West Roxbury, MA 02132-4335
Phone (617) 637-4640

825 S Watson Rd
Suite 106
Buckeye, AZ 85326-3435
Phone (480) 296-2987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Dec 30, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Dec 30, 2024 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

825 S Watson Rd
Ste 106
Buckeye, AZ 85326
Phone (623) 207-4015

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

380 N Estrella Pkwy
Ste A1
Goodyear, AZ 85338
Phone (480) 455-6266

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

197 Massachusetts Ave
Boston, MA 02115
Phone (617) 399-7330

425 Brookline Ave
Boston, MA 02215
Phone (617) 232-4018

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1164248407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S WATSON RD STE 106",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263435",
            "telephone_number": "623-207-4015",
            "fax_number": "623-471-8746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155410",
            "country_code": "US",
            "telephone_number": "617-232-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "KENDYLL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.