Kellie Jean Carpenter

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01779100 Issued in NJ

Practice address

221 W Grand Ave
Montvale, NJ 07645-1729

Phone

(201) 307-9209

NPI assigned

Mar 16, 2018

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

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sportscare of America, PC

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1851484380
  Medicare reassignment Care Compare group NPD
• United Sports Care & Physical Therapy

  • Occupational Therapist
  • Cedar Knolls, NJ
  • NPI 1972881233

  Physical Therapist

  Medicare reassignment NPD
• Kessler Institute for Rehabilitation, Inc.

  • Rehabilitation Hospital
  • Marlton, NJ
  • NPI 1528512266
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1114420049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WOODMERE LN",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W GRAND AVE",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451729",
            "telephone_number": "201-307-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KELLIE",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01779100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahitha Reddy Brown, DPT, ATC, NCPT
• Building Butterflies LLC
• Susan Buonocore, PH.D.
• Teresa Bustamante, NP-C
• Dhielan Bungay Bustos, DPT
• Deirdre B. Casey, MSN, RN, AGACNP-BC
• Patricia A Cavanna, RNFA
• Center for Resiliency, LLC
• Cesswell LLC
• Annmarie Champagne, PT

• Physical Therapist in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.