Individual provider Active NPI

Jeannine Kelly Kress, DPT

  • Physical Therapist
  • Shelby Township, MI
National Provider Identifier
1386822765
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013602 Issued in MI
Practice address
15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone
(568) 286-9644
Fax
(586) 286-9647
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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 5501013602 MI Primary

Addresses

Primary practice location

15023 21 Mile Rd
Shelby Township, MI 48315-5024

Mailing address

15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone (586) 286-9644

Other names 1

  • Mrs. Jeannine Kelly McDade Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000263 MI Practitioner - Physical Therapist in Private Practice 7810155405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Care Rehabilitation Professionals, IncGroup PAC ID 7618982471, 6 clinicians

Practice addresses (Care Compare)

15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone (586) 286-9644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501013602MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Rehabilitation Professionals, Inc Physical Therapist CurrentSince Jan 16, 2012 Accepting new patients
Quality Care Rehabilitation Professionals Past Accepting new patients

Locations

42536 Hayes Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 286-9644

15023 21 Mile Rd
Shelby Township, MI 48315
Phone (586) 286-9644

Organizations & group practices 2

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": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1386822765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024",
            "telephone_number": "568-286-9644",
            "fax_number": "586-286-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESS",
        "first_name": "JEANNINE",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNINE",
            "last_name": "MCDADE",
            "middle_name": "KELLY",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.