Individual provider Active NPI

Kelsey Marchetti, DPT

  • Physical Therapist
  • Hillsboro, OR
National Provider Identifier
1467187674
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64566 Issued in OR
Practice address
2875 NE Stucki Ave
Hillsboro, OR 97124-5806
Phone
(503) 813-2000
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 64566 OR Primary

Addresses

Primary practice location

2875 NE Stucki Ave
Hillsboro, OR 97124-5806

Mailing address

10 Forest Glen Cir Apt 18
Middletown, CT 06457-6657
Phone (401) 474-3876

Other practice location 1

80 Seymour St
Hartford, CT 06106-3315
Phone (860) 972-6760

Other identifiers 1

IdentifierTypeStateIssuer
64566OtherORPT LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL EPIC Health Information Exchange (HIE)
FHIR URL EPIC Health Information Exchange (HIE)

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
64566ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1467187674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FOREST GLEN CIR APT 18",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576657",
            "telephone_number": "401-474-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 NE STUCKI AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245806",
            "telephone_number": "503-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063315",
            "country_code": "US",
            "telephone_number": "860-972-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCHETTI",
        "first_name": "KELSEY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "64566",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "80 Seymour St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2875 NE Stucki Ave",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971245806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.