Individual provider Active NPI

Thomas Kellar, MSPT

  • Pediatric Physical Therapist
  • Rapid City, SD
National Provider Identifier
1487103602
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
0598 Issued in SD
Practice address
21 Saint Joseph St
Rapid City, SD 57701
Phone
(605) 394-1813
Fax
(605) 394-6766
NPI assigned
Sep 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 0598 SD Primary

Addresses

Primary practice location

21 Saint Joseph St
Rapid City, SD 57701

Mailing address

300 6TH St
Rapid City, SD 57701-5034
Phone (605) 394-1813

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
0598SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid City Area School District 51-4 Past Accepting new patients

Organizations & group practices 1

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": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1487103602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 6TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015034",
            "telephone_number": "605-394-1813",
            "fax_number": "605-394-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SAINT JOSEPH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-394-1813",
            "fax_number": "605-394-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAR",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SD",
            "license": "0598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.