Jean Kelly Bish, DPT
Individual provider Active NPI Physical Therapist · Wallace, NC
NPI 1235530973 · NPPES record last updated Jul 3, 2023
Key facts
- NPI
- 1235530973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 15141 (NC)
- Practice address
- 318 S Norwood St
Wallace, NC 28466-1446 - Phone
- (910) 285-1799
- Fax
- (910) 285-1899
- NPI assigned
- Sep 12, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vidant Medical Group LLC
Practice addresses (Care Compare)
318 S Norwood St
Wallace, NC 28466-1446
Phone (910) 285-1799
401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941
401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941
417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.95 of 100
- Quality
- 82.44
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141120000243 | NC | Practitioner - Physical Therapist in Private Practice | 5698997088 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15141 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Current |
Accepting new patients |
Locations
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
318 S Norwood St
Wallace, NC 28466
Phone (910) 285-1799
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 15141 | NC | Yes |
Addresses
Primary practice location
318 S Norwood St
Wallace, NC 28466-1446
Mailing address
318 S Norwood St
Wallace, NC 28466-1446
Phone (910) 285-1799
Other names
- Miss Jean Margaret Kelly
Other providers in Wallace, NC
- A Time of Refreshing Salon and Day Spa, LLC
- Sarah Anderson
- Corey Ryan Ayers
- Amy Bannerman
- Kern Lee Barrow
- Blair Family Medicine
- Mott Parks Blair IV
- Joseph Bologna
- Angela Boney
- Kathryn Elizabeth Rand Booher
All providers in Wallace, NC · Physical Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.