Individual provider Active NPI

Kelsey Noble

  • Orthopedic Physical Therapist
  • Media, PA
National Provider Identifier
1083370035
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT030005 Issued in PA
Practice address
280 N Providence Rd Ste 100
Media, PA 19063-3525
Phone
(610) 424-5800
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT030005 PA Primary

Addresses

Primary practice location

280 N Providence Rd Ste 100
Media, PA 19063-3525

Mailing address

475 Allendale Rd Ste 206
King of Prussia, PA 19406-1495
Phone (610) 270-0370

Other names 1

  • Kelsey Nieckoski Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123002012 PA Practitioner - Physical Therapist in Private Practice 3971993460 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Motive Sports and Physical Therapy Malvern LLCGroup PAC ID 7113459587, 15 clinicians

Practice addresses (Care Compare)

280 N Providence Rd
Suite 100
Media, PA 19063-3525
Phone (610) 424-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT030005PAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Motive Sports and Physical Therapy, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Orthopedic and Sports Physical Therapy Services, Inc. Orthopedic CurrentSince Nov 11, 2021 Accepting new patients
Progress Physical Therapy LLC Orthopedic CurrentSince Jul 21, 2024 Accepting new patients
Motive Sports and Physical Therapy Malvern, LLC Orthopedic CurrentSince Dec 24, 2024 Accepting new patients

Locations

120 E Lancaster Ave
Ste 205
Ardmore, PA 19003
Phone (484) 297-6491

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

91 Wilmington W Chester Pike
Ste 28
Chadds Ford, PA 19317
Phone (302) 584-5621

475 Allendale Rd
Ste 206
Kng of Prussa, PA 19406
Phone (610) 270-0370

101 Lindenwood Dr
Ste 225
Malvern, PA 19355
Phone (610) 504-4476

480 Lancaster Ave
Unit 4
Malvern, PA 19355
Phone (610) 500-5296

280 N Providence Rd
Ste 100
Media, PA 19063
Phone (610) 424-5800

555 E Lancaster Ave
Radnor, PA 19087
Phone (267) 507-7572

Organizations & group practices 4

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1083370035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ALLENDALE RD STE 206",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061495",
            "telephone_number": "610-270-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N PROVIDENCE RD STE 100",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633525",
            "telephone_number": "610-424-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT030005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "NIECKOSKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.