Active NPI
Wendy Lynn Kelley, DPT
- Pediatric Physical Therapist
- Copley, OH
National Provider Identifier
1316367618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 4764
- Practice address
- 30 Rothrock Loop Ste B
Copley, OH 44321-1331 - Phone
- (330) 666-2228
- Fax
- (330) 666-2223
- NPI assigned
- Apr 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 4764 | OH | Primary |
Addresses
Primary practice location
30 Rothrock Loop Ste B
Copley, OH 44321-1331
Mailing address
PO Box 14532
Copley, OH 44321-4532
Phone (330) 441-1241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316367618 | Other | OH | NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Copley | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4764 | OH | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1316367618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14532",
"city": "COPLEY",
"state": "OH",
"postal_code": "443214532",
"telephone_number": "330-441-1241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 ROTHROCK LOOP STE B",
"city": "COPLEY",
"state": "OH",
"postal_code": "443211331",
"telephone_number": "330-666-2228",
"fax_number": "330-666-2223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "WENDY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-24",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OH",
"license": "4764",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1316367618",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Copley",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Copley",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Copley",
"address_1": "30 Rothrock Loop Ste B",
"city": "Copley",
"state": "OH",
"country_code": "US",
"postal_code": "443211331",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Copley, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.