Kelli Michelle Dye McLaren, PT DPT SCS CMTPT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

PT010287 Issued in GA

Practice address

470 Northside Cherokee Blvd
Canton, GA 30115-8015

Phone

(678) 773-9117

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1104478643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 INDIAN TRACE DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300042584",
            "telephone_number": "678-773-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158015",
            "telephone_number": "678-773-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAREN",
        "first_name": "KELLI",
        "middle_name": "MICHELLE DYE",
        "credential": "PT DPT SCS CMTPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "PT010287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana McGuire, CNP-FAMILY
• Logan Charles McIntire, DMD
• Dennis Garrett McKenna, P.A.-C.
• Tania McKenzie-Ming, NP-C
• Amanda Lynne McKinley
• Maggie McLean
• Lisa McLeod, DO
• Kim M. McMillan, MA, LPC
• Emily McPeek
• Anna McQuaig

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Canton, GA
• Providers in Canton, GA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.