Individual provider Active NPI

Kelley London

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1861898009
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42685 Issued in CA
Practice address
811 Wilshire Blvd Ste 110
Los Angeles, CA 90017-2779
Phone
(213) 415-1990
NPI assigned
Nov 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 42685 CA Primary

Addresses

Primary practice location

811 Wilshire Blvd Ste 110
Los Angeles, CA 90017-2779

Mailing address

811 Wilshire Blvd Ste 110
Los Angeles, CA 90017-2779
Phone (213) 415-1990

Other practice location 1

729 Thimble Shoals Blvd
4 C
Newport News, VA 23606-4217
Phone (757) 873-2932

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

LicenseStateTypeSpecialty
42685CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Physical Therapy & Associates Inc. Past Accepting new patients
Innovative Medicine Physical Therapist PastSince Jul 24, 2022 Accepting new patients
Mdietician Inc PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861898009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 WILSHIRE BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172779",
            "telephone_number": "213-415-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 WILSHIRE BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172779",
            "telephone_number": "213-415-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "729 Thimble Shoals Blvd",
            "address_2": "4 C",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064217",
            "country_code": "US",
            "telephone_number": "757-873-2932",
            "fax_number": "757-873-8780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONDON",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.