Active NPI
Kelly Havlin, PT, DPT, MBA
- Physical Therapist
- Cleveland, OH
National Provider Identifier
1154031045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT019368
- Practice address
- 21225 Lorain Rd
Cleveland, OH 44126-2120 - Phone
- (440) 331-3180
- NPI assigned
- Dec 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT019368 | OH | Primary |
Addresses
Primary practice location
21225 Lorain Rd
Cleveland, OH 44126-2120
Mailing address
1563 Cordova Ave
Lakewood, OH 44107-3603
Phone (440) 665-4473
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT019368 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1215989611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1154031045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1563 CORDOVA AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073603",
"telephone_number": "440-665-4473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21225 LORAIN RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441262120",
"telephone_number": "440-331-3180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVLIN",
"first_name": "KELLY",
"credential": "PT, DPT, MBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-01",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT019368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.