Active NPI
Kelly Preddy
- Physical Therapist
- Austin, TX
National Provider Identifier
1629188149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 6818 Austin Center Blvd Ste 111
Austin, TX 78731-3199 - Phone
- (512) 418-8870
- NPI assigned
- Aug 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 | Primary |
Addresses
Primary practice location
6818 Austin Center Blvd Ste 111
Austin, TX 78731-3199
Mailing address
3905 Cologne LN
Austin, TX 78727-6010
Phone (512) 417-9751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1151456 | Other | TX | LICENSE # |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242691200000",
"number": "1629188149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3905 COLOGNE LN",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787276010",
"telephone_number": "512-417-9751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6818 AUSTIN CENTER BLVD STE 111",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787313199",
"telephone_number": "512-418-8870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREDDY",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2009-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "1151456",
"state": "TX"
}
],
"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, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.