Individual provider Active NPI

Kelly Hardy, DPT

  • Physical Therapist
  • Haverhill, MA
National Provider Identifier
1205121738
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19512 Issued in MA
Practice address
3 Ferry St
Suite F
Haverhill, MA 01835-7442
Phone
(978) 469-9412
Fax
(978) 469-0693
NPI assigned
Jun 13, 2011
Last updated
Feb 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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 19512 MA Primary

Addresses

Primary practice location

3 Ferry St
Suite F
Haverhill, MA 01835-7442

Mailing address

210 Commerce Way
Suite 120
Portsmouth, NH 03801-8200
Phone (207) 439-2675

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19512MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proex Physical Therapy, LLC Past Accepting new patients
Proex Physical Therapy, LLC Physical Therapist PastSince Sep 6, 2005 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1205121738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 COMMERCE WAY",
            "address_2": "SUITE 120",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038018200",
            "telephone_number": "207-439-2675",
            "fax_number": "207-439-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FERRY ST",
            "address_2": "SUITE F",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018357442",
            "telephone_number": "978-469-9412",
            "fax_number": "978-469-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "KELLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.