Gerard P Kelly, L.M.T.

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

008693 Issued in NY

Practice address

550 Broadway Ste 201
Massapequa, NY 11758-5013

Phone

(516) 815-3134

NPI assigned

Sep 16, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1811146772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 BROADWAY STE 201",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585013",
            "telephone_number": "516-815-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BROADWAY STE 201",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585013",
            "telephone_number": "516-815-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "GERARD",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "NY",
            "license": "008693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "658606689",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darren J Katz, DC
• Jill S Kaye, PT
• Dawn Renee Keenan
• Gina M. Keep, N.P.
• Brian J Kelly, LPN
• John P Kelly, RPA
• Caitlin Bree Kennedy, D.AC., L.AC
• Kristine Kenning
• Roger Kersten, D.O.
• Dennis M Kesden, MD

• Mechanotherapist in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Mechanotherapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.