Kelly B Kim-Campo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PI00006092 Issued in WA

Practice address

563 Madison Ave N
Bainbridge Island, WA 98110-1768

Phone

(206) 855-8455

Fax

(206) 855-8465

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly B Campo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Bainbridge Island Physical Therapy, LLC

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1639219868
  NPD (past)
• Port Gamble S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1518585579
  NPD (past)
• Port Gamble S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1760428650
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1962419481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101768",
            "telephone_number": "206-855-8455",
            "fax_number": "206-855-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101768",
            "telephone_number": "206-855-8455",
            "fax_number": "206-855-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-CAMPO",
        "first_name": "KELLY",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PI00006092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CAMPO",
            "middle_name": "B",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shealeen Maia Kennedy, M.ED., BCBA, LBA
• Daniel Webster Kent, RBT, CBT
• Shannon Kent, MS RD
• Gregory E Keyes, MD
• Jeremy Kier
• Jackie Kimpton
• Alison King
• Ruth Elizabeth King, FNP-C
• Shannon Nicole King, M.S.
• Cresaya Emiliana Kingsbury, M.A. LMHC

• Physical Therapist in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.