Individual provider Active NPI

Allison Lorraine Keneally, P.T.

  • Physical Therapist
  • Campbell, CA
National Provider Identifier
1831266774
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT291049 Issued in CA
Practice address
201 E Hamilton Ave
Campbell, CA 95008-0206
Phone
(408) 376-0900
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11473 MA
Physical Therapist 225100000X PT01782 RI
Physical Therapist 225100000X PT291049 CA Primary

Addresses

Primary practice location

201 E Hamilton Ave
Campbell, CA 95008-0206

Mailing address

1153 Stafford Dr
Cupertino, CA 95014-4968
Phone (781) 883-0190

Other identifiers 1

IdentifierTypeStateIssuer
0398314MedicaidMA

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)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
291049CAMDLicensed Vocational Nurse
PT291049CAMDPhysical Therapist
PT01782RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keneally Physical Therapy, PC CurrentSince Dec 22, 2019 Accepting new patients
Keneally Physical Therapy & Holistic Healing Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1831266774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 STAFFORD DR",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950144968",
            "telephone_number": "781-883-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080206",
            "telephone_number": "408-376-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENEALLY",
        "first_name": "ALLISON",
        "middle_name": "LORRAINE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11473",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01782",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT291049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0398314",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.