Dwain E Kelley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1101441 Issued in KS

Practice address

10300 W 103Rd St
Suite 300
Overland Park, KS 66212

Phone

(913) 894-1910

NPI assigned

Jun 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1972762714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10127 WEDD DR",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125443",
            "telephone_number": "913-438-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 W 103RD ST",
            "address_2": "SUITE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66212",
            "telephone_number": "913-894-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DWAIN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "R1062",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1101441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PT LICENSE",
            "identifier": "11-01441",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PT LICENSE",
            "identifier": "R1062",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lida Rose Keller, RN, BSN
• Steven G Keller, DPT
• Betsy Kellerman, ATC, LAT
• Anne Kelley
• Chelsie Kelley
• Kelly R. Moore Therapy LLC
• Abigael F Kelly, AUD
• Casandra Joyce Kelly, LCSW
• Catherina Annette Kelly, LSCSW
• Dana Leigh Kelly, MSN-FNP

• Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.