Kelly Maher

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61088530 Issued in WA

Practice address

275 W Tietan St
Walla Walla, WA 99362-4363

Phone

(509) 522-0114

NPI assigned

Aug 20, 2020

Last updated

Aug 20, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Walla Walla Physical Therapy Center Aps

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1477574606
  NPD

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1275145179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 KANIKSU LOOP RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628742",
            "telephone_number": "360-201-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624363",
            "telephone_number": "509-522-0114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1442 Kaniksu Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993628742",
            "country_code": "US",
            "telephone_number": "360-201-1009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61088530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Maceo
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• Alison Madsen
• Reid Magnaghi, DPT
• Mahmoud Maghsoudlou LLC (Aria Dental)
• Jessica Lynn Mai, O.D.
• Seng Mai, PHARMD
• Pablo Maldonado
• Samuel Malesky

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.