Leslie Suzanne Kelly, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AO1979 Issued in KY

Practice address

200 Norfleet Dr
Somerset, KY 42501-1952

Phone

(606) 678-5104

Fax

(606) 677-1925

NPI assigned

Jun 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073710406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 SYCAMORE DR",
            "city": "BRONSTON",
            "state": "KY",
            "postal_code": "425189679",
            "telephone_number": "606-561-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORFLEET DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425011952",
            "telephone_number": "606-678-5104",
            "fax_number": "606-677-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LESLIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "AO1979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew J Keith, MPA, M.ED, LPCC
• Jeana Lee Keith, APRN-CNP
• Melinda Marie Keith, CPSS
• Paula Keith
• Charissa Gene Kelly, MA CFY/SLP
• Rhonda Kelly, APRN
• Harry R Kennedy, M.D.
• James Thomas Kennett, PA-C
• Kenney Orthopedic, LLC
• Kentuckiana Hearing Service LLC (Somerset/Kentuckiana Hearing)

• Physical Therapy Assistant in Somerset, KY
• Providers in Somerset, KY by specialty
• Physical Therapy Assistant in Kentucky

• 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.