Kelly Jean Willbanks, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

18488 Issued in CA

Practice address

29650 Bradley Rd
Sun City, CA 92586-6521

Phone

(951) 672-0455

Fax

(951) 672-0206

NPI assigned

Oct 13, 2006

Last updated

Apr 2, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Walker Physical Therapy, IncGroup PAC ID 3072697879, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walker Physical Therapy, Inc

  • Physical Therapist
  • Sun City, CA
  • NPI 1154411650
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1942390596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29650 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866521",
            "telephone_number": "951-672-0455",
            "fax_number": "951-672-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29650 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866521",
            "telephone_number": "951-672-0455",
            "fax_number": "951-672-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLBANKS",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "18488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walker Physical Therapy, Inc
• John Lee Walker, M.O.M.T.
• James S Wee, DDS
• Weldon K Jackson (Sun City Hearing Service)
• White Oak Industries Inc. (Dragonfly Therapy)
• William M. Kelly M.D., Inc. (Health Scan Imaging)
• Rick Wright
• Zareh Family Dental Inc. (Docdental Smiles)
• Pete Richard Zesk

• Physical Therapist in Sun City, CA
• Providers in Sun City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.