Kalynne Marie Elliott

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502004912 Issued in MI

Practice address

62445 Shimmel Rd
Centreville, MI 49032-9527

Phone

(269) 467-5400

NPI assigned

Aug 25, 2026

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

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1225945439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11992 F DR S",
            "city": "CERESCO",
            "state": "MI",
            "postal_code": "490338708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62445 SHIMMEL RD",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490329527",
            "telephone_number": "269-467-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KALYNNE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502004912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Jo Delmark, RN
• Isabel Naomi Detwiler
• Geetha Dhatreecharan, M.D.
• Alexis Dines
• Melanie R Eifort, CPSS
• Diana Grace Evans, LBSW
• Linda Sue Evans, M.D.
• Katherine Ann Faist-Lutz
• Lauren Elizabeth Falkenstein
• Anna Marie Farley, LPC

• Physical Therapy Assistant in Centreville, MI
• Providers in Centreville, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.