Active NPI
Kelly A McGraw, MPT
- Physical Therapist
- South Charleston, WV
National Provider Identifier
1699802314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1535
- Practice address
- 4825 Maccorkle Ave SW Ste F
South Charleston, WV 25309-1365 - Phone
- (304) 346-9667
- NPI assigned
- Feb 28, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 7691 | TN | |
| Physical Therapist | 225100000X | 1535 | WV | Primary |
Addresses
Primary practice location
4825 Maccorkle Ave SW Ste F
South Charleston, WV 25309-1365
Mailing address
4825 Maccorkle Ave SW Ste F
South Charleston, WV 25309-1365
Phone (304) 346-9667
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1535 | WV | MD | Professional Counselor |
| 7691 | TN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1699802314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4825 MACCORKLE AVE SW STE F",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253091365",
"telephone_number": "304-346-9667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 MACCORKLE AVE SW STE F",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253091365",
"telephone_number": "304-346-9667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGRAW",
"first_name": "KELLY",
"middle_name": "A",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "7691",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "1535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.