Individual provider Active NPI

Parker Dean Nally, DPT

  • Physical Therapist
  • Kennebunk, ME
National Provider Identifier
1346961406
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6319 Issued in ME
Practice address
65 Portland Rd Ste 5
Kennebunk, ME 04043-6742
Phone
(207) 985-6181
NPI assigned
Sep 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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 PT6319 ME Primary

Addresses

Primary practice location

65 Portland Rd Ste 5
Kennebunk, ME 04043-6742

Mailing address

15 Holland Rd
Kennebunk, ME 04043-6296
Phone (978) 886-4935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028000924 ME Practitioner - Physical Therapist in Private Practice 0840667226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saco Bay Orthopaedic and Sports Physical Therapy IncGroup PAC ID 9537069265, 137 clinicians

Practice addresses (Care Compare)

65 Portland Rd
Suite 5
Kennebunk, ME 04043-6742
Phone (207) 985-6181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist CurrentSince Jul 5, 2022 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Jul 5, 2022 Accepting new patients

Locations

65 Portland Rd
Ste 5
Kennebunk, ME 04043
Phone (207) 985-6181

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

Organizations & group practices 2

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1346961406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HOLLAND RD",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436296",
            "telephone_number": "978-886-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PORTLAND RD STE 5",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436742",
            "telephone_number": "207-985-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLY",
        "first_name": "PARKER",
        "middle_name": "DEAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.