Andrea Lyn Kelly, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501302025 Issued in MI

Practice address

24 Frank Lloyd Wright Drive
Lobby M, Suite 2800
Ann Arbor, MI 48105-9484

Phone

(734) 936-9795

NPI assigned

Sep 19, 2022

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

State licenses

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1285356014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31220 SUNSET DR",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "LOBBY M, SUITE 2800",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-936-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANDREA",
        "middle_name": "LYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Natalie Kellogg, PA C
• Sheila Anne Kellogg, CRNA
• Marilyn Doermann Kellum
• Kelly a Grocoff LLC
• Aine Marie Kelly, MB, BCH, BAO
• Brian M Kelly, DO
• Jack E Kelly, PT, DPT
• Kazia Ann Kelly, MSW
• Meghan Kelly, MD
• Patricia E Kelly, M.D.

• Physical Therapist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.