Individual provider Active NPI

Susan Hess Kelo, M.S.P.T.

  • Physical Therapist
  • Chester, VA
National Provider Identifier
1356543243
Registry record updated Mar 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205119 Issued in VA
Practice address
12212 Branders Creek Rd
Chester, VA 23831-1626
Phone
(804) 425-4545
NPI assigned
Jun 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305205119 VA Primary

Addresses

Primary practice location

12212 Branders Creek Rd
Chester, VA 23831-1626

Mailing address

8424 Kintail Dr
Chesterfield, VA 23838-5182
Phone (804) 882-6137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230427000389 VA Practitioner - Physical Therapist in Private Practice 4789049727 Reassigns benefits to 2 organizations
I20240514003392 DC Practitioner - Physical Therapist in Private Practice 4789049727 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305205119VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Mar 9, 2023 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince May 1, 2024 Accepting new patients
Mike Kelo Physical Therapy, PLLC Physical Therapist PastSince Feb 1, 2009 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

4870 Sadler Rd
Ste 300
Glen Allen, VA 23060
Phone (757) 524-2304

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426982400000",
    "number": "1356543243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 KINTAIL DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238385182",
            "telephone_number": "804-882-6137",
            "fax_number": "804-425-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12212 BRANDERS CREEK RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311626",
            "telephone_number": "804-425-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELO",
        "first_name": "SUSAN",
        "middle_name": "HESS",
        "name_prefix": "Mrs.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-03",
        "last_updated": "2015-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.