Kelly Ann Facteau, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11004 Issued in MA

Practice address

6 Bayberry CT
Nantucket, MA 02554-4039

Phone

(508) 825-8191

Fax

(508) 825-8198

NPI assigned

Aug 31, 2018

Last updated

Aug 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Granite State Physical Therapy Hooksett PLLCGroup PAC ID 1153321401, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Granite State Physical Therapy Hooksett PLLC

  • Physical Therapist
  • Hooksett, NH
  • NPI 1437218872
  Medicare reassignment Care Compare group NPD
• Nantucket Cottage Hospital

  dba Nantucket Cottage Medical Group

  • Rural Health Clinic/Center
  • Nantucket, MA
  • NPI 1477021608
  NPD (past)

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1003398546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7619",
            "city": "SIASCONSET",
            "state": "MA",
            "postal_code": "025647619",
            "telephone_number": "508-642-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BAYBERRY CT",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544039",
            "telephone_number": "508-825-8191",
            "fax_number": "508-825-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACTEAU",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "01215",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4343",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Duquette, CRNA
• Stacey Leah Dutra, MSW
• Kaitlyn Amy Erisman, DPT
• Darcie Linn Evans, LICSW
• Karen J. Eveleth
• Fairwinds-Nantucket's Counseling Center, Inc
• Fairwinds-Nantuckets Counseling Center
• Family and Children's Services of Nantucket
• Family and Children's Services of Nantucket
• Alison M Fassnacht, PA-C

• Physical Therapist in Nantucket, MA
• Providers in Nantucket, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.