Active NPI
Kevin A. Kelley, DPT
- Physical Therapist
- Moline, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-019925
- Practice address
- 850 43Rd Ave Ste 300
Moline, IL 61265-8401 - Phone
- (309) 743-0300
- NPI assigned
- May 24, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-019925 | IL | Primary |
| Physical Therapist | 225100000X | 1104573 | KS |
Addresses
Primary practice location
850 43Rd Ave Ste 300
Moline, IL 61265-8401
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3385 Dexter CT
Suite 203
Davenport, IA 52807-3471
Phone (563) 332-9312
902 Illini Dr
Silvis, IL 61282-4700
Phone (309) 796-3450
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-019925 | IL | MD | Physical Therapist |
| 1104573 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Valley Physical Therapy Center | Physical Therapist | Current | Accepting new patients |
| Rock Valley Physical Therapy Center | Physical Therapist | Current | Accepting new patients |
Locations
1705 N Ankeny Blvd
Ste A
Ankeny, IA 50023
Phone (515) 446-0733
1427 S Washington Blvd
Camanche, IA 52730
Phone (563) 259-4440
2635 Lincoln Way
Ste C
Clinton, IA 52732
Phone (563) 243-8321
3385 Dexter Ct
Ste 203
Davenport, IA 52807
Phone (563) 332-9312
1905 Ingersoll Ave
Ste 104
Des Moines, IA 50309
Phone (515) 369-2306
3414 Northport Dr
Ste 2
Muscatine, IA 52761
Phone (563) 263-2639
419 W Bridge Rd
Ste A
Polk City, IA 50226
Phone (515) 984-6377
5700 University Ave
Ste 222
West Des Moines, IA 50266
Phone (309) 743-2070
1225 S Oakwood Ave
Ste 1
Geneseo, IL 61254
Phone (309) 944-6447
850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300
850 43rd Ave
Ste 200
Moline, IL 61265
Phone (309) 743-0300
850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070
9901 N Knoxville Ave
Ste D
Peoria, IL 61615
Phone (309) 243-1989
9317A Il Route 84
Savanna, IL 61074
Phone (815) 273-2628
902 Illini Dr
Silvis, IL 61282
Phone (309) 796-3450
1013 N Cummings Ln
Washington, IL 61571
Phone (309) 444-1030
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.
-
- Occupational Therapist
- Eldridge, IA
- NPI 1881540490
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1508203936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 300",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "KEVIN",
"middle_name": "A.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-24",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-019925",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "1104573",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.