Kelsey O'Leary

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MASG-1598 Issued in ID

Practice address

960 S Broadway Ave
Suite 200
Boise, ID 83706-3600

Phone

(208) 433-9211

Fax

(208) 433-9241

NPI assigned

Oct 9, 2015

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 names 1

• Kelsey Marie Kleinkopf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1164893657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 S BROADWAY AVE",
            "address_2": "SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063600",
            "telephone_number": "208-433-9211",
            "fax_number": "208-433-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MASG-1598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "KLEINKOPF",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rory Stephen O'Connor, PHYSICIAN ASSISTANT
• Sara M O'Connor, NP
• Janat E. O'Donnell, MD
• Kevin O'Donnell, FNP
• Kelly O'Leary
• Nikki E O'Leary, OTR/L CLT
• Anna O'Malley, MS, LPC
• Hali O'Malley, PHARMD
• Cynthia O'Neil, RD, LD, IBCLC
• Shirley O'Neil, M.ED., LPC

• Massage Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.