Individual provider Active NPI

Stephen Kellett, DPT

  • Physical Therapist
  • Des Moines, WA
National Provider Identifier
1902340102
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60705963 Issued in WA
Practice address
22659 Pacific Hwy S
Suite 201
Des Moines, WA 98198-5155
Phone
(206) 824-3668
NPI assigned
Dec 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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 PT60705963 WA Primary

Addresses

Primary practice location

22659 Pacific Hwy S
Suite 201
Des Moines, WA 98198-5155

Mailing address

22659 Pacific Hwy S
Suite 201
Des Moines, WA 98198-5155
Phone (206) 824-3668

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

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1902340102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22659 PACIFIC HWY S",
            "address_2": "SUITE 201",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981985155",
            "telephone_number": "206-824-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22659 PACIFIC HWY S",
            "address_2": "SUITE 201",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981985155",
            "telephone_number": "206-824-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLETT",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60705963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.