Kelly Jean Desselle, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2025021797 Issued in MO

Practice address

1207 NW Pamela Blvd
Grain Valley, MO 64029-7844

Phone

(816) 867-6022

NPI assigned

Jun 18, 2024

Last updated

May 5, 2026By the provider in NPPES

Sex

Female

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

Enrolled in KS, MO2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upward Physical Therapy LLCGroup PAC ID 0244761666, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Upward Physical Therapy, LLC

  dba Onward Performance & Physical Therapy

  • Physical Therapist
  • Grain Valley, MO
  • NPI 1629835780
  Medicare reassignment Care Compare group NPD
• Specialists in Sports and Orthopedic Rehabilitation LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1134493075
  Medicare reassignment NPD

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1366285116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NW PAMELA BLVD",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "640297844",
            "telephone_number": "816-867-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 NW PAMELA BLVD",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "640297844",
            "telephone_number": "816-867-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESSELLE",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2025021797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Crosson
• Randall Lee Culbertson, DO
• Cwo Enterprises (Children With Opportunity)
• Caton Day
• Jenny De Marziani, PT
• Diamond Medical Care LLC
• Kayla Dominguez, DC
• Kennedi Douglas
• Catherine Dowd, D.C.
• Kaitlin Doyle

• Physical Therapist in Grain Valley, MO
• Providers in Grain Valley, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.