Individual provider Active NPI

Kelly Duszak McArdle, PT, DPT, CERT.MDT

  • Specialist
  • Philadelphia, PA
National Provider Identifier
1912104639
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT011690 Issued in PA
Practice address
501 South 54TH Street
Suite 127
Philadelphia, PA 19143
Phone
(215) 748-9160
Fax
(215) 748-9724
NPI assigned
Jun 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT011690 PA Primary

Addresses

Primary practice location

501 South 54TH Street
Suite 127
Philadelphia, PA 19143

Mailing address

508 S 7TH St
Apt 3
Philadelphia, PA 19147-1411
Phone (215) 748-9160

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
PT011690PAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912104639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S 7TH ST",
            "address_2": "APT 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471411",
            "telephone_number": "215-748-9160",
            "fax_number": "215-748-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SOUTH 54TH STREET",
            "address_2": "SUITE 127",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19143",
            "telephone_number": "215-748-9160",
            "fax_number": "215-748-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCARDLE",
        "first_name": "KELLY",
        "middle_name": "DUSZAK",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT, CERT.MDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "PT011690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.