Darryl Mathew Kelleher, B.S.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00002811 Issued in WA

Practice address

3711 Pacific Ave Ste 101
Tacoma, WA 98418-7800

Phone

(253) 475-4415

Fax

(253) 475-3034

NPI assigned

Aug 31, 2006

Sex

Male

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 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2183/brand/322/csg/2142/fhir/r4

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.

• Adult Rehabilitation Therapies, PLLC

  • Physical Therapist
  • Federal Way, WA
  • NPI 1194943381
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215049622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 PACIFIC AVE STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187800",
            "telephone_number": "253-475-4415",
            "fax_number": "253-475-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 PACIFIC AVE STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187800",
            "telephone_number": "253-475-4415",
            "fax_number": "253-475-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "DARRYL",
        "middle_name": "MATHEW",
        "credential": "B.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L AND I",
            "identifier": "32331",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO, POS, EPO",
            "identifier": "4454296",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650016424",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUNDVIEW CRIMEVICTIMSLI",
            "identifier": "8914812",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR-OWCP-ACS",
            "identifier": "336786200",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7160054",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8333940",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS L AND I",
            "identifier": "8914810",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO, QPOS US ACCESS",
            "identifier": "2378617",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "KE0554",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerald Keister, PT
• Charles Jerome Keith
• Jacob Stephen Keith, MD
• Teresa Elizabeth Keith, RN
• Jonathan Michael Kell, MD
• Don Keller
• Julia Marie Keller, MA, LMHC, CDPT
• Chris Kelley
• Georgie Kelley, P.A.
• Glen E Kelley

• Physical Therapist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.