Individual provider Active NPI

Kimberly K. McElroy, PT

  • Physical Therapist
  • Austin, TX
National Provider Identifier
1477634970
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1184808 Issued in TX
Practice address
6835 Austin Center Blvd
Austin, TX 78731-3166
Phone
(512) 346-6611
Fax
(512) 465-1633
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5182 AZ
Physical Therapist 225100000X 1184808 TX Primary

Addresses

Primary practice location

6835 Austin Center Blvd
Austin, TX 78731-3166

Mailing address

PO Box 26726
Austin, TX 78755-0726
Phone (512) 407-8686

Other identifiers 1

IdentifierTypeStateIssuer
753823MedicaidAZ

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

LicenseStateTypeSpecialty
5182AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialty Clinic, PC Past Accepting new patients
East Valley Physical Therapy & Aquatic Rehabilitation LTD Physical Therapist PastSince Nov 1, 1999 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1477634970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26726",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787550726",
            "telephone_number": "512-407-8686",
            "fax_number": "512-421-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6835 AUSTIN CENTER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313166",
            "telephone_number": "512-346-6611",
            "fax_number": "512-465-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELROY",
        "first_name": "KIMBERLY",
        "middle_name": "K.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5182",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1184808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "753823",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.