Kelly L King, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000007078 Issued in TN

Practice address

309 Highway 641 N
Camden, TN 38320-3011

Phone

(731) 584-1722

Fax

(731) 584-1733

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

Yes

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.

• Dynamix Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Milan, TN
  • NPI 1669619268

  TN

  Medicare reassignment Care Compare group NPD
• PT Associates, LLC

  • Physical Therapist
  • Camden, TN
  • NPI 1649290933
  NPD
• Kerry D. Friesen, M.D. PC

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1316052624
  NPD (past)
• Dynamix Physical Therapy LLC

  • Physical Therapist
  • Corinth, MS
  • NPI 1962295576
  NPD (past)

Specialty

Physical Therapist in Private Practice

Education

University of Tennessee, HSC, College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dynamix Physical Therapy LLC 46 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 12, 2014.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1699709204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 HIGHWAY 641 N",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383203011",
            "telephone_number": "731-584-1722",
            "fax_number": "731-584-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HIGHWAY 641 N",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383203011",
            "telephone_number": "731-584-1722",
            "fax_number": "731-584-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000007078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446685",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "4117317",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry M Hudson, RN
• Lisa Irwin
• J & S Pharmacy Inc
• Angela Ruth Jones, MS
• Jordan Kee
• Heather Larkins, NP
• Cynthia Audrey Lewis
• Ross B Lumpkin, OD
• Deborah M Malin, DPH
• Leslie Marchus, LPC

• All providers in Camden, TN
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.