Active NPI
Kelly Ann Duke, DPT
- Physical Therapist
- Cedar Park, TX
National Provider Identifier
1437404191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3111391
- Practice address
- 2519 S Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964 - Phone
- (512) 331-6200
- Fax
- (512) 331-4312
- NPI assigned
- Jul 18, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3111391 | TX | Primary |
Addresses
Primary practice location
2519 S Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964
Mailing address
2519 S Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964
Phone (512) 331-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3111391 | Other | TX | LICENSE TX TEMP DPT |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3111391 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1437404191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2519 S LAKELINE BLVD",
"address_2": "SUITE 100",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786132964",
"telephone_number": "512-331-6200",
"fax_number": "512-331-4312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2519 S LAKELINE BLVD",
"address_2": "SUITE 100",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786132964",
"telephone_number": "512-331-6200",
"fax_number": "512-331-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUKE",
"first_name": "KELLY",
"middle_name": "ANN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-18",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "3111391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE TX TEMP DPT",
"identifier": "3111391",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedar Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.