Kelsey Kate Idom, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11173 Issued in LA

Practice address

4624 Cypress St Ste 8
West Monroe, LA 71291-1348

Phone

(318) 654-7439

NPI assigned

Jul 26, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelsey Kate Osbon 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.

• Building Futures

  • Speech-Language Pathologist
  • Monroe, LA
  • NPI 1770672073

  Single Specialty

  NPD (past)
• Thrive Pediatric Therapy

  • Speech-Language Pathologist
  • West Monroe, LA
  • NPI 1932877529
  NPD (past)

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1346976032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HENDERSON RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712919409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 CYPRESS ST STE 8",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712911348",
            "telephone_number": "318-654-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOM",
        "first_name": "KELSEY",
        "middle_name": "KATE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA BOARD OF PHYSICAL THERAPY",
            "identifier": "11173",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "OSBON",
            "middle_name": "KATE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Iasis Glenwood Regional Medical Center LP
• Iasis Glenwood Regional Medical Center LP
• Iasis Glenwood Regional Medical Center LP
• Iasis Glenwood Regional Medical Center LP
• Iasis Ouachita Community Hospital LP
• Innovated Medical Services, LLC
• Introspective Counseling LLC
• IV Solutions LLC
• J.P. Rosales, K.R. Malmay & M.P. O'Boyle Dba Children'S Hospital Care
• Rima Imad Jaber

• Physical Therapist in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.