Jennifer Marie Kelly, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4483 Issued in OR

Practice address

55 NW Wall St Ste 100
Bend, OR 97703-3200

Phone

(541) 389-4321

Fax

(541) 389-4420

NPI assigned

Nov 30, 2005

Last updated

Oct 7, 2016By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Falling Waters LLCGroup PAC ID 9638200991, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Falling Waters LLC

  • Chiropractor
  • Bend, OR
  • NPI 1154449890
  Medicare reassignment Care Compare group NPD
• Anchorage Fracture and Orthopaedic Clinic, PC

  dba Alaska Fracture and Orthopedic Clinic

  • Orthopaedic Surgery Physician
  • Anchorage, AK
  • NPI 1285677054
  NPD (past)
• Anchorage Fracture and Orthopaedic Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Wasilla, AK
  • NPI 1831774298
  NPD (past)
• Orthoalaska LLC

  dba Orthopedic Physicians Alaska

  • Rheumatology Physician
  • Anchorage, AK
  • NPI 1265293252
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1417931817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NW WALL ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033200",
            "telephone_number": "541-389-4321",
            "fax_number": "541-389-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NW WALL ST STE 100",
            "address_2": "0",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033200",
            "telephone_number": "541-389-4321",
            "fax_number": "541-389-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4483",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1723",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299148",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Belczyk LCSW LLC
• Carol Lee Kelly
• Casie Kelly, LMT
• Chelsea Catherine Kelly, CRM
• Jandi Kelly, MS, PHD
• Kara Lynn Kelly, N.P.
• Linda J Kelly, LCSW
• Lindsey Rhodes Kelly, RDN
• Crystal Kelso, DMD
• Kemple Memorial Children's Dental Clinic

• Physical Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.