Active NPI
Kelly J McLearran, PT
- Physical Therapist
- Oro Valley, AZ
National Provider Identifier
1528096179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3289
- Practice address
- 1617 W Placita Montuoso
Oro Valley, AZ 85737-3677 - Phone
- (520) 300-1634
- Fax
- (520) 797-3530
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3289 | AZ | Primary |
Addresses
Primary practice location
1617 W Placita Montuoso
Oro Valley, AZ 85737-3677
Mailing address
1617 W Placita Montuoso
Oro Valley, AZ 85737-3677
Phone (520) 300-1634
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 548315 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3289 | AZ | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foothills Sports Medicine & Rehabilitation- Tucson, LLC | Physical Therapist | Current | Accepting new patients |
| Straight 2U Physical Therapy | Current | Accepting new patients |
Locations
15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822
7575 W Twin Peaks Rd
Ste 155
Tucson, AZ 85743
Phone (520) 290-1665
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.
-
- Physical Therapy Clinic/Center
- Oro Valley, AZ
- NPI 1376168856
-
- Physical Therapist
- Tucson, AZ
- NPI 1205921202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1528096179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1617 W PLACITA MONTUOSO",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857373677",
"telephone_number": "520-300-1634",
"fax_number": "520-797-3530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 W PLACITA MONTUOSO",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857373677",
"telephone_number": "520-300-1634",
"fax_number": "520-797-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEARRAN",
"first_name": "KELLY",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "3289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "548315",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oro Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.