Eric Kelly Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025342 Issued in NY

Legal business name

ERIC KELLY PHYSICAL THERAPY PLLC

Practice address

1 Conway CT
Troy, NY 12180-2108

Phone

(518) 273-2715

Fax

(518) 273-2815

NPI assigned

Jan 3, 2018

Organization subpart

No

Name

Eric Michael Kelly, PTNPI 1487750824

Title

Physical Therapist/Owner

Phone

(518) 273-2715

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Michael Kelly, DPT, MS, CSCS

  • Physical Therapist
  • Troy, NY
  • NPI 1487750824

  NY, Physical Therapist

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in NY

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 3, 2018.

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514937600000",
    "number": "1225545932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CONWAY CT",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802108",
            "telephone_number": "518-273-2715",
            "fax_number": "518-273-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CONWAY CT",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802108",
            "telephone_number": "518-273-2715",
            "fax_number": "518-273-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC KELLY PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "518-273-2715",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Troy, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.