Mark Christopher Kelly, MS, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00565000 Issued in NJ

Practice address

1 Brace Rd Ste a
Cherry Hill, NJ 08034

Phone

(856) 470-9191

Fax

(856) 310-9829

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  NPD (past)
• Strive Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Philadelphia, PA
  • NPI 1659962587

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1356449755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 STRAWBRIDGE DR STE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574602",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRACE RD STE A",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "856-470-9191",
            "fax_number": "856-310-9829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 Route 70",
            "address_2": "Suite 10",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080558704",
            "country_code": "US",
            "telephone_number": "609-714-7733",
            "fax_number": "609-714-7750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 Marne Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573127",
            "country_code": "US",
            "telephone_number": "856-914-1400",
            "fax_number": "856-914-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00565000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothea Sandra Kelly, MSW, LCSW
• Eileen Kelly, PT
• Jessica L Kelly, MS, OTR/L
• Jill Robin Kelly, OTRL
• Kristen Kelly, OTD
• Matthew Kelly
• Melanie Nicole Kelly, OTR/L
• Peter Kelly, D.O.
• Sharon Kelly, NP
• Shirlise Kathleen Kelly, MEC,MLC

• Physical Therapist in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.