Active NPI
Kelly Michele McCall, MSPT
- Physical Therapist
- Milwaukie, OR
National Provider Identifier
1962694299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4009
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4009 | OR | MD | Naturopath |
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.