Kellie Fokin, DPT, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

03136 Issued in RI

Practice address

765 Allens Ave
Providence, RI 02905-5443

Phone

(401) 444-3500

NPI assigned

Sep 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD (past)

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1659854438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 WEST ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055443",
            "telephone_number": "401-444-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOKIN",
        "first_name": "KELLIE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "RI",
            "license": "03136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Foderaro, M.D.
• Marjorie Rosenthal Foer, M.A., CCC-SLP
• Shelby Fofana, LCSW
• John L Foggle, MD
• Kathryn Fokas, PH.D.
• Dale Lynn Folan, LICSW
• Colin Andrew Foley, MD
• Following Seas Health
• Jessie Fong, ATC
• Tiago Fonseca Lizardo

• Pediatric Physical Therapist in Providence, RI
• Providers in Providence, RI by specialty
• Pediatric Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; 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.