Derek Kelton

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070028643 Issued in IL

Practice address

2325 W Monroe St
Springfield, IL 62704-1452

Phone

(217) 547-2497

NPI assigned

Jun 21, 2018

Last updated

Nov 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as apm

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.kelton.1@28977.direct.athenahealth.com

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.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment Care Compare group NPD
• Blue Ridge Physical Therapy, Inc

  • Physical Therapist
  • Independence, MO
  • NPI 1477596500
  Medicare reassignment NPD
• Arc Physical Therapy Plus LP

  • Physical Therapist
  • Overland Park, KS
  • NPI 1851715353

  MO

  Medicare reassignment

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1386138444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 W MONROE ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041452",
            "telephone_number": "217-547-2497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4460 S Noland Rd",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "64055",
            "country_code": "US",
            "telephone_number": "816-373-2845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELTON",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breana Kelley, DO
• Christina Noel Kelley, PA
• Pamela Sue Kelley, C.N.P.
• Colleen E Kelly, PA
• Judith Kelly, MD
• Kortni Michell Kemper, MD
• Kelly Ann Kendall, LCSW
• Kristen Elaine Kendall, M.D.
• Kendrick & Jones Dental, LLC
• Samuel D Kendrick, DMD

• Physical Therapist in Springfield, IL
• Providers in Springfield, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.