Kelly Sue Kishbaugh, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015072 Issued in PA

Practice address

410 Glenn Ave
Suite 101
Bloomsburg, PA 17815-1200

Phone

(570) 387-2135

NPI assigned

Mar 4, 2008

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

Other names 1

• Kelly Sue Molinaro Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Geisinger Encompass Health Limited Liability Company

  • Rehabilitation Hospital
  • Danville, PA
  • NPI 1811961758
  NPD (past)
• Susquehanna Physical Therapy Associates, Inc.

  • Physical Therapy Clinic/Center
  • Lewisburg, PA
  • NPI 1073557898
  NPD (past)

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1295905487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 MOUNT PLEASANT RD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178157246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 GLENN AVE",
            "address_2": "SUITE 101",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151200",
            "telephone_number": "570-387-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHBAUGH",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MOLINARO",
            "middle_name": "SUE",
            "credential": "MSPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• King Medical Care, Inc.
• John King, PHD
• Megan Kingsbury
• Dawn Kingston
• Genevieve Kinney
• Ardie Kissinger
• April K Kleiman, RN
• Mary Kleiner
• Bernard Klemchak
• Amber Lynn Kline, CNM

• Physical Therapist in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.