Individual provider Active NPI

Kelton Retherford, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1265149223
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
300214 Issued in CA
Practice address
6801 Park Terrace Drive
Ste 200
Los Angeles, CA 90045-1546
Phone
(310) 665-7100
NPI assigned
Oct 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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 300214 CA Primary

Addresses

Primary practice location

6801 Park Terrace Drive
Ste 200
Los Angeles, CA 90045-1546

Mailing address

6801 Park Terrace Drive
Ste 200
Los Angeles, CA 90045-1546
Phone (310) 665-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319002665 CA Practitioner - Physical Therapist in Private Practice 5597287581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

6801 Park Ter
Suite 200
Los Angeles, CA 90045-1546
Phone (310) 665-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
300214CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. Physical Therapist CurrentSince Mar 6, 2025 Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Retherford Physical Therapy Inc. Current Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Mar 6, 2025 Accepting new patients

Locations

6801 Park Ter
Ste 200
Los Angeles, CA 90045
Phone (310) 621-7583

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1265149223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 PARK TERRACE DRIVE",
            "address_2": "STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451546",
            "telephone_number": "310-665-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TERRACE DRIVE",
            "address_2": "STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451546",
            "telephone_number": "310-665-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETHERFORD",
        "first_name": "KELTON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.