Active NPI
Kelly Lee Coney Pacious, PT, DPT
- Physical Therapist
- Mount Holly, NC
National Provider Identifier
1407094642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P11957
- Practice address
- 328 Whippoorwill Lane
Mount Holly, NC 28120 - Phone
- (704) 827-3788
- NPI assigned
- Jan 26, 2009
- Last updated
- Feb 4, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | P11957 | NC | |
| Physical Therapist | 225100000X | P11957 | NC | Primary |
Addresses
Primary practice location
328 Whippoorwill Lane
Mount Holly, NC 28120
Mailing address
PO Box 1036
Shining Hope Farms
Mount Holly, NC 28120
Phone (704) 827-3788
Other names 1
- Dr. Kelly Lee Coney
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
| License | State | Type | Specialty |
|---|---|---|---|
| P11957 | NC | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shining Hope Farms | Physical Therapist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359936000000",
"number": "1407094642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1036",
"address_2": "SHINING HOPE FARMS",
"city": "MOUNT HOLLY",
"state": "NC",
"postal_code": "28120",
"telephone_number": "704-827-3788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 WHIPPOORWILL LANE",
"city": "MOUNT HOLLY",
"state": "NC",
"postal_code": "28120",
"telephone_number": "704-827-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONEY PACIOUS",
"first_name": "KELLY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-26",
"last_updated": "2013-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NC",
"license": "P11957",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P11957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "CONEY",
"middle_name": "LEE",
"prefix": "DR.",
"credential": "PT, DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Holly, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.