Individual provider Active NPI

Kelly Locke

  • Physical Therapist
  • Conway, NH
National Provider Identifier
1639258460
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1684 Issued in NH
Practice address
37 Main St
Conway, NH 03818-6166
Phone
(603) 447-2533
NPI assigned
Nov 3, 2006
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1444 ME
Physical Therapist 225100000X 1684 NH Primary

Addresses

Primary practice location

37 Main St
Conway, NH 03818-6166

Mailing address

568 Main St
Fryeburg, ME 04037-1146
Phone (207) 935-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060104000134 NH Practitioner - Physical Therapist in Private Practice 9436171519 Reassigns benefits to 1 organization
I20081120000495 ME Practitioner - Physical Therapist in Private Practice 9436171519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saco Bay Orthopaedic and Sports Physical Therapy IncGroup PAC ID 9537069265, shared by 4 NPIs, 137 clinicians

Practice addresses (Care Compare)

37 Main St
Conway, NH 03818-6166
Phone (603) 447-2533

568 Main St
Fryeburg, ME 04037-1288
Phone (207) 935-7770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1684NHMDDental Hygienist
1444MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist Current Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Dec 1, 2022 Accepting new patients

Locations

568 Main St
Fryeburg, ME 04037
Phone (207) 935-3500

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

37 Main St
Conway, NH 03818
Phone (603) 447-2533

75 Newport Rd
Unit 4
New London, NH 03257
Phone (603) 526-2781

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1639258460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 MAIN ST",
            "city": "FRYEBURG",
            "state": "ME",
            "postal_code": "040371146",
            "telephone_number": "207-935-7770",
            "fax_number": "207-935-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 MAIN ST",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186166",
            "telephone_number": "603-447-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "1444",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "1684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.

Verify at the official NPI Registry.