Kelly A Carroll, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12162 Issued in MA

Practice address

129 E Main St
Westborough, MA 01581-1578

Phone

(774) 210-0304

NPI assigned

Mar 14, 2012

Last updated

Feb 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly A Wilk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1386919074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WIGWAM RD",
            "city": "WEST BROOKFIELD",
            "state": "MA",
            "postal_code": "015853201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E MAIN ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811578",
            "telephone_number": "774-210-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "12162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WILK",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Cardin, P.T.
• Daniel Carew, DPT
• Stephanie Carlson, LMHC
• Nikkola Carmichael, CGC
• Charlene A Carr, COTA/L
• Kathleen Casamento, RN
• Rayon Case
• Marilyn Casey, COTA/L
• Castlebrook Counseling Services, Inc.
• Michelle D Caty, PT

• Physical Therapist in Westborough, MA
• Providers in Westborough, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.