Active NPI
Kathryn Pellegrom Riley, PT
- Physical Therapist
- Charlotte, MI
National Provider Identifier
1346753209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501005391
- Practice address
- 1790 Packard Hwy
Charlotte, MI 48813-9717 - Phone
- (517) 541-8747
- NPI assigned
- Nov 14, 2017
- Last updated
- Nov 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 5501005391 | MI | Primary |
Addresses
Primary practice location
1790 Packard Hwy
Charlotte, MI 48813-9717
Mailing address
5931 Summerfield CT
Haslett, MI 48840-8998
Phone (517) 896-3145
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 |
|---|---|---|---|
| 5501005391 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510617600000",
"number": "1346753209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5931 SUMMERFIELD CT",
"city": "HASLETT",
"state": "MI",
"postal_code": "488408998",
"telephone_number": "517-896-3145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 PACKARD HWY",
"city": "CHARLOTTE",
"state": "MI",
"postal_code": "488139717",
"telephone_number": "517-541-8747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KATHRYN",
"middle_name": "PELLEGROM",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-14",
"last_updated": "2017-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501005391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, MI
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- Latasha Jolee Reisinger
- Renal Care Group Charlotte, LLC (Fresenius Medical Care Charlotte)
- Renee L.I. Owen DDS PC
- Sherri Lynn Rinard
- Rising Phoenix Psychology and Counseling LLC
- Robert B Coon DMD PLLC
- Robert D Rolle P.C.
- Rolle and Dewitt Chiropractic Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.