Individual provider Active NPI

Kelley Warner, DPT

  • Physical Therapist
  • Lone Tree, CO
National Provider Identifier
1568611986
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL0015961 Issued in CO
Practice address
6024 Puma Chase
Lone Tree, CO 80124-9422
Phone
(303) 323-9998
NPI assigned
Sep 9, 2008
Last updated
May 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305205888 VA
Physical Therapist 225100000X 22875 MD
Physical Therapist 225100000X PTL0015961 CO Primary
Orthopedic Physical Therapist 2251X0800X 33849 CA

Addresses

Primary practice location

6024 Puma Chase
Lone Tree, CO 80124-9422

Mailing address

6024 Puma Chase
Lone Tree, CO 80124-9422
Phone (303) 323-9998

Other practice location 1

2450 El Camino Real
Suite 101
Palo Alto, CA 94306
Phone (650) 565-8090

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelley@modernmommypt.com Direct

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
PTL0015961COMDPhysical Therapist
2305205888VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back 2 Motion CurrentSince Aug 1, 2013 Accepting new patients
Redondo Orthopedic Physical Therapy Physical Therapist PastSince Jan 1, 2016 Accepting new patients
Agile Physical Therapy Inc PastSince Jan 1, 2007 Accepting new patients
Peak Performance PT Inc Physical Therapist Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1568611986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6024 PUMA CHASE",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801249422",
            "telephone_number": "303-323-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6024 PUMA CHASE",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801249422",
            "telephone_number": "303-323-9998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 El Camino Real",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "94306",
            "country_code": "US",
            "telephone_number": "650-565-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNER",
        "first_name": "KELLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205888",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22875",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0015961",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "33849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelley@modernmommypt.com",
            "affiliation": "N",
            "endpointDescription": "Business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "6024 Puma Chase",
            "city": "Lone Tree",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801249422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.