Kelly Ann Facteau, PT
Individual provider Active NPI Physical Therapist · Nantucket, MA
NPI 1003398546 · NPPES record last updated Aug 31, 2018
Key facts
- NPI
- 1003398546
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11004 (MA)
- Practice address
- 6 Bayberry CT
Nantucket, MA 02554-4039 - Phone
- (508) 825-8191
- Fax
- (508) 825-8198
- NPI assigned
- Aug 31, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- 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 PLLC
Practice addresses (Care Compare)
369 Hounsell Ave
Suite 8
Gilford, NH 03249-6996
Phone (603) 527-8015
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190114000051 | NH | Practitioner - Physical Therapist in Private Practice | 4486665023 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01215 | RI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granite State Physical Therapy Hooksett PLLC | Physical Therapist | Current |
Accepting new patients |
| Nantucket Cottage Hospital | Past | Accepting new patients |
Locations
6 Loudon Rd
Ste 5
Concord, NH 03301
Phone (603) 410-6309
369 Hounsell Ave
Ste 8
Gilford, NH 03249
Phone (603) 527-8015
1558 Hooksett Rd
Ste 5
Hooksett, NH 03106
Phone (603) 695-6767
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 01215 | RI | |
| Physical Therapist | 225100000X | 4343 | NH | |
| Physical Therapist | 225100000X | 11004 | MA | Yes |
Addresses
Primary practice location
6 Bayberry CT
Nantucket, MA 02554-4039
Mailing address
PO Box 7619
Siasconset, MA 02564-7619
Phone (508) 642-0003
Other providers in Nantucket, MA
- Peter Duquette
- Stacey Leah Dutra
- Kaitlyn Amy Erisman
- Darcie Linn Evans
- 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
All providers in Nantucket, MA · Physical Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.