Individual provider Active NPI

Rex Rory William De Pentheny O'Kelly, LMT

  • Massage Therapist
  • Bellingham, WA
National Provider Identifier
1396347464
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
61110422 Issued in WA
Practice address
2930 Newmarket St Ste 115
Bellingham, WA 98226-3870
Phone
(360) 656-5131
NPI assigned
Nov 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 61110422 WA Primary

Addresses

Primary practice location

2930 Newmarket St Ste 115
Bellingham, WA 98226-3870

Mailing address

647 W Horton Way Apt 236
Bellingham, WA 98226-7344
Phone (360) 389-6888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61110422WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Luther and Luther PLLC CurrentSince Nov 15, 2020 Accepting new patients

Locations

2930 Newmarket St
Ste 115
Bellingham, WA 98226
Phone (360) 347-2609

Organizations & group practices 1

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": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1396347464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 W HORTON WAY APT 236",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267344",
            "telephone_number": "360-389-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 NEWMARKET ST STE 115",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982263870",
            "telephone_number": "360-656-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE PENTHENY O'KELLY",
        "first_name": "REX",
        "middle_name": "RORY WILLIAM",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "61110422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

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