Individual provider Active NPI

Kelly A Austin, DC, PT

  • Physical Therapist
  • Chandler, AZ
National Provider Identifier
1851411433
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4386 Issued in AZ
Practice address
1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-9662
Phone
(480) 821-1997
Fax
(480) 821-1887
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 5911 AZ
Physical Therapist 225100000X 4386 AZ Primary

Addresses

Primary practice location

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-9662

Mailing address

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-5225
Phone (480) 821-1997

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

Practice roles

OrganizationSpecialtyStatusNew patients
360 Physical Therapy LLC Physical Therapist Past Accepting new patients
Active Care Chiropractic, Inc. Past Accepting new patients
360 Physical Therapy LLC Past Accepting new patients

Organizations & group practices 3

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1851411433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD",
            "address_2": "STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245225",
            "telephone_number": "480-821-1997",
            "fax_number": "480-821-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD",
            "address_2": "STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852249662",
            "telephone_number": "480-821-1997",
            "fax_number": "480-821-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "AZ",
            "license": "5911",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "4386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.