Active NPI
Kelsey R Carley, DPT
- Physical Therapist
- Pontiac, IL
National Provider Identifier
1336537133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.021217
- Practice address
- 1521 W Reynolds St
Pontiac, IL 61764-9673 - Phone
- (815) 844-2464
- NPI assigned
- Dec 31, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.021217 | IL | Primary |
Addresses
Primary practice location
1521 W Reynolds St
Pontiac, IL 61764-9673
Mailing address
1521 W Reynolds St
Pontiac, IL 61764-9673
Phone (815) 844-2464
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.021217 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1336537133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649673",
"telephone_number": "815-844-2464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649673",
"telephone_number": "815-844-2464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLEY",
"first_name": "KELSEY",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-31",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.021217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.