Mary Virginia Kelley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-004954 Issued in KY

Practice address

4584 Newport Ave
San Diego, CA 92107-2924

Phone

(859) 312-9909

NPI assigned

Sep 29, 2008

Last updated

Sep 18, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jay West Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Oakland, CA
  • NPI 1629651237

  Physical Therapist

  NPD (past)
• Montclair Physical Therapy, Inc.

  dba Active Method Physical Therapy

  • Physical Therapist
  • Oakland, CA
  • NPI 1699791897
  NPD (past)
• Simon Gibson

  dba Montclair Physical Therapy

  • Physical Therapist
  • Oakland, CA
  • NPI 1497099451
  NPD (past)

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1467602284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4584 NEWPORT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072924",
            "telephone_number": "859-312-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4584 NEWPORT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072924",
            "telephone_number": "859-312-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT-004954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Marie Kelley, DPT, PT, ATC
• Lauren Kelley, D.O
• Leon R Kelley, MD
• Lynne A Kelley, LCSW
• Maria Teresa Kelley, LCSW
• Michael L Kelley, RN, BSN, IBCLC
• Rose D Kelley, BCBA
• Sara Marciadene Kelley, JD
• Shena Kelley
• Walter Benton Kelley III

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

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

Verify at the official NPI Registry.