Individual provider Active NPI

Brennan C Kelsey, PT

  • Physical Therapist
  • Amite, LA
National Provider Identifier
1003856790
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02637 Issued in LA
Practice address
215 NW Central Ave
Amite, LA 70422-2426
Phone
(985) 747-3422
Fax
(985) 747-3424
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02637 LA Primary

Addresses

Primary practice location

215 NW Central Ave
Amite, LA 70422-2426

Mailing address

215 NW Central Ave
Amite, LA 70422-2426
Phone (985) 747-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104000203 LA Practitioner - Physical Therapist in Private Practice 0749478931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Louisiana State University School of Medicine in New Orleans, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 NW Central Ave
Amite, LA 70422-2426
Phone (985) 747-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
02637LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey Enterprises LLC CurrentSince Oct 11, 2010 Accepting new patients
Rehabilitation & Sports Care Center LLC Physical Therapist Current Accepting new patients

Locations

14159 Highway 16
Amite, LA 70422
Phone (504) 747-3422

215 NW Central Ave
Amite, LA 70422
Phone (985) 747-3422

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1003856790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NW CENTRAL AVE",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222426",
            "telephone_number": "985-747-3422",
            "fax_number": "985-747-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NW CENTRAL AVE",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222426",
            "telephone_number": "985-747-3422",
            "fax_number": "985-747-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "BRENNAN",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "02637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amite, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.