Kaci Cathleen Kelly

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5226 Issued in TN

Practice address

719 S Main St Ste 104
Springfield, TN 37172-2809

Phone

(615) 480-4792

NPI assigned

Jun 20, 2021

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

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

{
    "created_epoch": "1624147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624147200000",
    "number": "1215506761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5728 WOODALE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122616",
            "telephone_number": "865-240-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 S MAIN ST STE 104",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371722809",
            "telephone_number": "615-480-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KACI",
        "middle_name": "CATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-20",
        "last_updated": "2021-06-20",
        "certification_date": "2021-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "5226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Slama Jones, LPTA
• Nellanne Jones
• Nicole Jones
• Kaylee Jorgensen, OTD-OTR/L
• Melissa T. Judd, RN
• Lynda Sims Kerbo, PT
• Jane Kershaw, RN, IBCLC
• Cierra Kimbrough, FNP
• Justin Rakim King, MD
• Michael Klomp, PT, DPT

• Physical Therapy Assistant in Springfield, TN
• Providers in Springfield, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2021; 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.