Kelly Egan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004579 Issued in KY

Practice address

101 E State St
Kennett Square, PA 19348-3109

Phone

(800) 367-5690

NPI assigned

Feb 12, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1407270341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "800-367-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "KELLY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "90410R",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Michelle Duva, PHARMD
• Michael J Duzy, DO
• Kellianne Eckman, M.A.
• Philip Randall Eckman Jr., D.D.S.
• Philip Randall Eckman Sr., DDS MAGD
• Eldercare Resources Corp
• Leon Ellerb Jr., OTA/L 2838
• Merribeth H Elling, PT
• Annette Blower Ernst, OT
• Karen Erwin, MS, CCC-SLP

• Physical Therapist in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.