Kelly G Reece, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27240 Issued in FL

Practice address

130 Forum Dr Ste 13
Columbia, SC 29229-7943

Phone

(803) 509-6880

NPI assigned

Mar 29, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kelly L Gonzalez Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drayer Physical Therapy-South Carolina ,LLCGroup PAC ID 7315171394, 43 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Drayer Physical Therapy-South Carolina, LLC

  • Physical Therapist
  • Columbia, SC
  • NPI 1841622354
  Medicare reassignment Care Compare group NPD
• Drayer Physical Therapy - South Carolina, LLC

  • Physical Therapist
  • Camden, SC
  • NPI 1154816833
  NPD
• Treehouse Therapies, LLC

  • Pediatric Physical Therapist
  • Fort Walton Beach, FL
  • NPI 1083380828
  NPD (past)
• Treehouse Therapies, LLC

  • Speech-Language Pathologist
  • Fort Walton Beach, FL
  • NPI 1972800639

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1346516770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOLLYWOOD BLVD SW STE 7",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484893",
            "telephone_number": "850-226-7411",
            "fax_number": "850-613-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FORUM DR STE 13",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297943",
            "telephone_number": "803-509-6880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Hollywood Blvd SW Ste 7",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325484893",
            "country_code": "US",
            "telephone_number": "850-226-7411",
            "fax_number": "850-613-6515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REECE",
        "first_name": "KELLY",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10043",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004801700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GONZALEZ",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Columbia, SC
• Providers in Columbia, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.