Individual provider Active NPI

Kellie Suzanne Massie-Osborne, P.T.

  • Specialist
  • Saint Petersburg, FL
National Provider Identifier
1073684080
Registry record updated Apr 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
FLPT16875 Issued in FL
Practice address
419 Pasadena Ave S
Saint Petersburg, FL 33707-2101
Phone
(727) 384-4600
Fax
(727) 384-4601
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X FLPT16875 FL Primary

Addresses

Primary practice location

419 Pasadena Ave S
Saint Petersburg, FL 33707-2101

Mailing address

2865 Boca Ciega Dr N
Saint Petersburg, FL 33710-2829
Phone (727) 244-1771

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914001386 FL Practitioner - Physical Therapist in Private Practice 3870618887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Physical Therapy and Wellness IncGroup PAC ID 5294787735, 8 clinicians

Practice addresses (Care Compare)

13777 Belcher Rd S
Largo, FL 33771-4096
Phone (727) 532-1900

419 Pasadena Ave S
St Petersburg, FL 33707-2101
Phone (727) 384-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FLPT16875FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Physical Therapy and Wellness Inc CurrentSince Nov 14, 2024 Accepting new patients
Seabreeze Physical Therapy, Inc. Specialist PastSince Dec 14, 2011 Accepting new patients

Locations

14280 Walsingham Rd
Largo, FL 33774
Phone (727) 596-2101

13777 Belcher Rd S
Largo, FL 33771
Phone (727) 532-1900

419 Pasadena Ave S
St Petersburg, FL 33707
Phone (727) 384-4600

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775952000000",
    "number": "1073684080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 BOCA CIEGA DR N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337102829",
            "telephone_number": "727-244-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 PASADENA AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337072101",
            "telephone_number": "727-384-4600",
            "fax_number": "727-384-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIE-OSBORNE",
        "first_name": "KELLIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2026-04-12",
        "certification_date": "2026-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "FLPT16875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2026; 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.