Kelly Marie Shistle

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT027899 Issued in PA

Practice address

10475 Perry Hwy Ste 106G
Wexford, PA 15090-9213

Phone

(877) 407-3422

Fax

(877) 407-4329

NPI assigned

Aug 6, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, MA, NJ, MD, DC, SC, VA7 enrollments

Enrollment records 7

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fox Rehabilitation Services LLCGroup PAC ID 1355347410, 304 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fox Rehabilitation Services LLC

  • Physical Therapist
  • Winchester, VA
  • NPI 1609814755

  DC

  Medicare reassignment Care Compare group NPD
• Fox Rehab Ma LLC

  • Physical Therapist
  • Waltham, MA
  • NPI 1497174437
  Medicare reassignment NPD
• Fox Rehab PT MD LLC

  • Physical Therapist
  • Timonium, MD
  • NPI 1588901847
  Medicare reassignment NPD
• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ, PA

  Medicare reassignment NPD
• Fox Rehabilitation Services of South Carolina, LLC

  • Physical Therapist
  • Lexington, SC
  • NPI 1902133689
  Medicare reassignment NPD

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1154976256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 PERRY HWY STE 106G",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909213",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHISTLE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT027899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab MA LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "391 Common St",
            "city": "Dedham",
            "state": "MA",
            "country_code": "US",
            "postal_code": "020264055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Marie Shellhammer, CRNP
• Pramita Anil Shenoy, MSOTR/L
• Craig James Shepherd, D.M.D.
• Brian R Shidemantle, DPT
• Tejaswini S Shinde
• Macie Ann Shober
• Jacqueline M Shock-Stewart, LCSW
• Karly Elizabeth Shorts, LPC
• Stephanie Lynn Shriver, LPC
• Jocelyn Shuber, MA, CCC-SLP

• Physical Therapist in Wexford, PA
• Providers in Wexford, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.