NPIMap

Individual provider Active NPI

Kelly Ann Conley, D.P.T.

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1033235007
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007747 Issued in GA
Practice address
3300 Northeast Expressway NE
Building 8, Suite C
Atlanta, GA 30341
Phone
(770) 500-3848
Fax
(678) 868-1114
NPI assigned
Mar 22, 2007
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7747 GA
Physical Therapist 225100000X PT007747 GA Primary

Addresses

Primary practice location

3300 Northeast Expressway NE
Building 8, Suite C
Atlanta, GA 30341

Mailing address

3300 Northeast Expressway NE
Building 8, Suite C
Atlanta, GA 30341
Phone (770) 500-3848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000553 GA Practitioner - Physical Therapist in Private Practice 1052580461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7747GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esop Rehabilitation, LLC Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
Esop Rehabilitation, LLC Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
Esop Rehabilitation LLC Physical Therapist Current Accepting new patients
Activcore Health Network LLC Physical Therapist PastSince Apr 1, 2022 Accepting new patients
One on One Physical Therapy Past Accepting new patients

Locations

875 Flat Shoals Rd SE
Ste 150
Conyers, GA 30094
Phone (770) 785-7669

199 Medical Blvd
Stockbridge, GA 30281
Phone (404) 808-0155

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1033235007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 NORTHEAST EXPRESSWAY NE",
            "address_2": "BUILDING 8, SUITE C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "770-500-3848",
            "fax_number": "678-868-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NORTHEAST EXPRESSWAY NE",
            "address_2": "BUILDING 8, SUITE C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "770-500-3848",
            "fax_number": "678-868-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "7747",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.