Active NPI
Kelli Marie Selby, DPT
- Neurology Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1205338753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- 5501016904
- Practice address
- 235 Wealthy
Grand Rapids, MI 49504 - Phone
- (616) 840-8000
- NPI assigned
- Mar 1, 2018
- 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 |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | 5501016904 | MI | Primary |
Addresses
Primary practice location
235 Wealthy
Grand Rapids, MI 49504
Mailing address
1151 Van Ess Ave NW
Grand Rapids, MI 49504
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501016904 | MI | MD | Neurology Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569888000000",
"number": "1205338753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 VAN ESS AVE NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 WEALTHY",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49504",
"telephone_number": "616-840-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELBY",
"first_name": "KELLI",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-01",
"last_updated": "2019-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "MI",
"license": "5501016904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.