Individual provider Active NPI

Jill Michelle Hansen Kehl, PT, DSC

  • Physical Therapist
  • Roswell, GA
National Provider Identifier
1073673877
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6349 Issued in GA
Practice address
345 Ridge CT
Roswell, GA 30076-2620
Phone
(770) 641-9239
Fax
(866) 813-0830
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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 6349 GA Primary

Addresses

Primary practice location

345 Ridge CT
Roswell, GA 30076-2620

Mailing address

4190 Dunwoody Ter
Atlanta, GA 30341-1054
Phone (678) 427-7060

Other identifiers 1

IdentifierTypeStateIssuer
00856952BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6349GAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Therapy Services, LLC Physical Therapist PastSince May 25, 2021 Accepting new patients
Excellence in Therapy, Inc. PastSince May 25, 2021 Accepting new patients

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1073673877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 DUNWOODY TER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411054",
            "telephone_number": "678-427-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 RIDGE CT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762620",
            "telephone_number": "770-641-9239",
            "fax_number": "866-813-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHL",
        "first_name": "JILL",
        "middle_name": "MICHELLE HANSEN",
        "name_prefix": "Ms.",
        "credential": "PT, DSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "6349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00856952B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.