Individual provider Active NPI

Kelly Michele McCall, MSPT

  • Physical Therapist
  • Milwaukie, OR
National Provider Identifier
1962694299
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4009 Issued in OR
Practice address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone
(971) 206-5102
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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 4009 OR Primary

Addresses

Primary practice location

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

Mailing address

1995 Proctor Rd
Mosier, OR 97040-9752

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
4009ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1962694299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 PROCTOR RD",
            "city": "MOSIER",
            "state": "OR",
            "postal_code": "970409752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "KELLY",
        "middle_name": "MICHELE",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.