Individual provider Active NPI

Kelly Marie Dellinger

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1386874956
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012519 Issued in OH
Practice address
222 Piedmont Ave
Suite 2200
Cincinnati, OH 45219-4231
Phone
(513) 621-7777
Fax
(513) 221-5761
NPI assigned
Jul 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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 012519 OH Primary

Addresses

Primary practice location

222 Piedmont Ave
Suite 2200
Cincinnati, OH 45219-4231

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Kelly Marie Mushill Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150914000493 SC Practitioner - Physical Therapist in Private Practice 3072820786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RSFH - Ati Physical Therapy LLCGroup PAC ID 3375849946, 98 clinicians

Practice addresses (Care Compare)

2070 Northbrook Blvd
Suite A9
North Charleston, SC 29406-9253
Phone (843) 824-2183

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
89.43
Improvement activities
40
Cost
74.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012519OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33299 Collection Ctr Dr
Chicago, IL 60693

900 Island Park Dr
Ste 108
Daniel Island, SC 29492
Phone (843) 284-5285

116 Foxbank Plantation Blvd
Ste E
Moncks Corner, SC 29461
Phone (843) 761-4622

5401 Netherby Ln
Ste 300
North Charleston, SC 29420
Phone (843) 225-5211

8950 University Blvd
Ste 200A
North Charleston, SC 29406
Phone (843) 414-1140

9241 University Blvd
Ste B1
North Charleston, SC 29406
Phone (843) 414-1140

2070 Northbrook Blvd
Ste A9
North Charleston, SC 29406
Phone (843) 377-0268

606 Nexton Square Dr
Ste 304
Summerville, SC 29486
Phone (843) 376-5963

1718 State Rd
Ste 7D
Summerville, SC 29486
Phone (843) 303-9418

330 E 5th North St
Ste De
Summerville, SC 29483
Phone (843) 695-0326

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1386874956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "address_2": "SUITE 2200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-621-7777",
            "fax_number": "513-221-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLINGER",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "012519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MUSHILL",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.