Kellie Ann Stanley, OTR/L
Individual provider Active NPI Physical Therapy Clinic/Center · Abingdon, MD
NPI 1104013549 · NPPES record last updated Dec 5, 2012
Key facts
- NPI
- 1104013549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 05678 (MD)
- Practice address
- 3465 Box Hill Corporate Center Dr
Ste G
Abingdon, MD 21009-1261 - Phone
- (410) 569-4806
- Fax
- (410) 568-5474
- NPI assigned
- Oct 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Total Rehab at Home, Inc.
Practice addresses (Care Compare)
227 Bank St
Chesapeake City, MD 21915-1016
Phone (410) 392-2731
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080102000684 | MD | Practitioner - Occupational Therapist in Private Practice | 5890875850 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05678 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Rehab at Home, Inc. | Current |
Accepting new patients |
Locations
139 E High St
Elkton, MD 21921
Phone (410) 392-2731
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 05678 | MD | Yes |
Addresses
Primary practice location
3465 Box Hill Corporate Center Dr
Ste G
Abingdon, MD 21009-1261
Mailing address
1812 Marsh Rd
Store 505
Wilmington, DE 19810-4581
Phone (302) 793-0432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5070-0090 | Other | CARE FIRST | |
| 2191733361 | Other | CHAMPUS TRICARE | |
| 3316154000 | Other | IBC AMERIHEALTH | |
| 92838701 | Other | CARE FIRST | |
| 214147 | Other | JOHNS HOPKINS |
Other providers in Abingdon, MD
- Asheesh Sood
- Specialized ABA Services LLC
- Bernadette Sroka-Franczkowski
- Taylor Mae Stager
- Angela N Stamidis
- Stephanie Harding, DDS, P.C.
- Renee P Stokes
- Strategic Therapeutic Solutions
- Jyotsna R Supnekar
- Supreme Home Care Services Inc.
All providers in Abingdon, MD · Physical Therapy Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.