Kelly Hall Boutchyard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

5567 N Croatan Hwy
Kitty Hawk, NC 27949-4090

Phone

(252) 261-1556

Fax

(252) 261-6161

NPI assigned

Apr 27, 2009

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

Other names 1

• Kelly Ann Boothe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Coastal Rehabilitation Inc

  • Physical Therapist
  • Manteo, NC
  • NPI 1346466430
  NPD (past)
• Coastal Rehabilitation Inc

  • Physical Therapist
  • Elizabeth City, NC
  • NPI 1457418311
  NPD (past)
• Coastal Rehabilitation Inc

  • Physical Therapist
  • Kitty Hawk, NC
  • NPI 1871610907
  NPD (past)

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1801030499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CAROLINA CT W",
            "city": "MANTEO",
            "state": "NC",
            "postal_code": "279549545",
            "telephone_number": "252-338-2114",
            "fax_number": "252-338-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5567 N CROATAN HWY",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279494090",
            "telephone_number": "252-261-1556",
            "fax_number": "252-261-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTCHYARD",
        "first_name": "KELLY",
        "middle_name": "HALL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BOOTHE",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bear Drugs Inc
• Bear Drugs Inc.
• Jacquelyn Forrest Best
• Shelly Kay Blackstone, MSW, LCSW-A
• Carri E Blankenship, PHYSICAL THERAPIST
• Christina Michelle Bowen, MD
• Donna Brickhouse, CRNA
• Michael D Buglione, PA-C
• Troy Lincoln Burchett, MD
• Bonnie Campion, RPH

• All providers in Kitty Hawk, NC
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; 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.