Individual provider Active NPI

Laura Lynne Kelahan, MPT

  • Physical Therapist
  • Clinton TWP, MI
National Provider Identifier
1043537228
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015866 Issued in MI
Practice address
42536 Hayes Rd
Suite 100
Clinton TWP, MI 48038-6766
Phone
(586) 286-9644
Fax
(586) 286-9647
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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 5501015866 MI Primary

Addresses

Primary practice location

42536 Hayes Rd
Suite 100
Clinton TWP, MI 48038-6766

Mailing address

42536 Hayes Rd
Suite 100
Clinton TWP, MI 48038-6766
Phone (586) 286-9644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160708000788 MI Practitioner - Physical Therapist in Private Practice 3274825476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Health Alliance LLCGroup PAC ID 2860776648, 3 clinicians

Practice addresses (Care Compare)

395 N Groesbeck Hwy
Suite L
Mount Clemens, MI 48043-1561
Phone (586) 630-0474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Health Alliance LLC Physical Therapist CurrentSince Aug 21, 2017 Accepting new patients
Quality Care Rehabilitation Professionals Past Accepting new patients

Locations

395 N Groesbeck Hwy
Ste L
Mount Clemens, MI 48043
Phone (586) 630-0474

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": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1043537228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42536 HAYES RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386766",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42536 HAYES RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386766",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELAHAN",
        "first_name": "LAURA",
        "middle_name": "LYNNE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.