Lisa Ann Kelty, PT, MHS

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4 Oak Ridge Dr
Spring Valley, IL 61362-1043

Phone

(815) 663-5029

Fax

(815) 663-2101

NPI assigned

Feb 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053447102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OAK RIDGE DR",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621043",
            "telephone_number": "815-663-5029",
            "fax_number": "815-663-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OAK RIDGE DR",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621043",
            "telephone_number": "815-663-5029",
            "fax_number": "815-663-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT, MHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Emmanuel Candia Honorio
• Hospital Radiology Service, S.C.
• Lisa Jacobs, APNC
• David Wayne Johnson, R.PH
• Michelle A Kelley, CRNA
• Kelsey Jennifer Klein, LSW
• Adam Kress
• Beth Kunkel, O.D.
• Kent Kunkel, O.D.
• Leonard Michael Kuzmicki, DPM

• All providers in Spring Valley, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.