Kellie Jean Fox, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012519-1 Issued in NY

Practice address

600 Northern Blvd
Albany, NY 12204

Phone

(518) 429-2566

NPI assigned

May 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Lisa Johnson Physical Therapy PLLCGroup PAC ID 7618254152, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lisa Johnson Physical Therapy, PLLC

  • Orthopedic Physical Therapist
  • Sarasota, FL
  • NPI 1427595784
  Medicare reassignment Care Compare group NPD
• Sports and Orthopedic Rehabilitation Services, Inc.

  • Physical Therapy Clinic/Center
  • Sarasota, FL
  • NPI 1093415655
  NPD

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1164623591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 2ND ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342364905",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12204",
            "telephone_number": "518-429-2566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Albany Shaker Road",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121106412",
            "country_code": "US",
            "telephone_number": "518-220-9413",
            "fax_number": "518-220-9417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "KELLIE",
        "middle_name": "JEAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012519-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX I.D.#",
            "identifier": "311774947",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03048340",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alaina Jordan Foust
• Heidi Mazzara Fowler, PT, DPT
• Bianca Passos Fox, RD
• Jeffrey H Fox, PHD
• Justin Isaac Fox, D.D.S.
• Megan Fox
• Edward J. Fraley III
• Stephanie Talbot France, LCSW
• Erika Frances, PSY.D
• Amanda Lynn Francese, ANP

• Physical Therapist in Albany, NY
• Providers in Albany, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.