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1194985044 NPI number — CHRISTINA LORRAINE KELLEY DPT

NPI Number: 1194985044
Health Care Provider/Practitioner: CHRISTINA LORRAINE KELLEY DPT

Information about “1194985044” NPI (CHRISTINA LORRAINE KELLEY DPT) exists in 1194985044 in HTML format HTML  |  1194985044 in plain Text format TXT  |  1194985044 in PDF (Portable Document Format) PDF  |  1194985044 in an XML format XML  formats.

NPI Number : 1194985044 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194985044",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KELLEY",
    "FirstName": "CHRISTINA",
    "MiddleName": "LORRAINE",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SHINABERY",
    "OtherFirstName": "CHRISTINA",
    "OtherMiddleName": "LORRAINE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "250 N SHADELAND AVE STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46219-4959",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-963-3177",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1701 N SENATE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46202-5306",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-963-2172",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/13/2008",
    "LastUpdateDate": "07/21/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "05008700A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2251C2600X",
          "TaxonomyName": "Cardiopulmonary Physical Therapist",
          "LicenseNumber": "05008700A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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