Individual provider Active NPI

Kelly Lay

  • Physical Therapist
  • Severna Park, MD
National Provider Identifier
1053978676
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
645 Baltimore Annapolis Blvd Ste 111
Severna Park, MD 21146-3956
Phone
(410) 544-2500
NPI assigned
May 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd Ste 111
Severna Park, MD 21146-3956

Mailing address

8213 Royal Star CT
Pasadena, MD 21122-3860
Phone (443) 974-0108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191028000573 MD Practitioner - Physical Therapist in Private Practice 4789916636 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

551 Baltimore Annapolis Blvd
Suite D
Severna Park, MD 21146-3809
Phone (443) 441-0676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Aug 26, 2019 Accepting new patients
Cypress Creek Therapy Associates LLC Physical Therapist CurrentSince May 30, 2023 Accepting new patients
Privia Medical Group, LLC Current Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 10, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 10, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients

Locations

161 Jennifer Rd
Ste A
Annapolis, MD 21401

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

2000 Medical Pkwy
Ste 404
Annapolis, MD 21401

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

70 Central Ave W
Edgewater, MD 21037
Phone (410) 481-1140

20 Mayo Rd
Ste 205
Edgewater, MD 21037
Phone (410) 384-9242

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146
Phone (410) 544-2500

551 Baltimore Annapolis Blvd
#D
Severna Park, MD 21146
Phone (443) 441-0676

Interoperability endpoints

  • Direct secure messaging: kelly.lay.1@8042.direct.athenahealth.com

Organizations & group practices 6

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": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1053978676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8213 ROYAL STAR CT",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211223860",
            "telephone_number": "443-974-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD STE 111",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463956",
            "telephone_number": "410-544-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.