Victoria P Kellan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01195500 Issued in NJ

Practice address

1591 Yanceyville St Ste 400
Greensboro, NC 27405-6945

Phone

(336) 274-7480

Fax

(336) 274-8903

NPI assigned

Apr 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Victoria Peterson Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of North Carolina at Chapel Hill School of Medicine, 1999

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment Care Compare group NPD
• Access PT, OT, New York, PLLC

  • Physical Therapist
  • New City, NY
  • NPI 1831539493
  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Breakthrough Physical Therapy

  • Physical Therapist
  • Morehead City, NC
  • NPI 1083937692
  NPD (past)
• Sparta Fit for Life, LLC

  • Physical Therapist
  • Sparta, NJ
  • NPI 1326193426
  NPD (past)
• Tu Rehab LLC

  • Physical Therapy Clinic/Center
  • Oradell, NJ
  • NPI 1235576679

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1013973445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MOUNT PLEASANT RD",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 YANCEYVILLE ST STE 400",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056945",
            "telephone_number": "336-274-7480",
            "fax_number": "336-274-8903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Main St",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "NJ",
            "postal_code": "078711930",
            "country_code": "US",
            "telephone_number": "973-729-1222",
            "fax_number": "973-729-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLAN",
        "first_name": "VICTORIA",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01195500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "PETERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keith G Kordsmeier DDS PA
• Jason B Keith, MSW, LCSW
• Kayla N Keith, PA-C
• Preston Wylie Keith, DDS
• Ebony R Keitt, DC
• Lisa Kelledy, PHD, LMFT
• Rachael Teresa Kelleher, M.S.
• Carolyn Keller, PA-C
• Edweana Katrice Keller, FNP-C
• Hilary Keller

• Physical Therapist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.