Kelly Phelps – Physical Therapy Assistant

Key facts

NPI: 1396065652
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: 06003469A (IN)
Practice address: 118 Medical Dr
Carmel, IN 46032-2923
Phone: (317) 573-1037
NPI assigned: Jun 9, 2010
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
06003469A	IN	MD	Physical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	06003469A	IN	Yes

Addresses

Primary practice location

118 Medical Dr
Carmel, IN 46032-2923

Mailing address

118 Medical Dr
Carmel, IN 46032-2923
Phone (317) 573-1037

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 9, 2010.

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1396065652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MEDICAL DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322923",
            "telephone_number": "317-573-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEDICAL DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322923",
            "telephone_number": "317-573-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003469A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Amy Pfeffenberger
Dana Pflugradt
Kelsey Elise Pflum, PTA
Pharmakon Pharmaceuticals
Kamolphob Phasuk, D.D.S.
Scott E Phillips, MD
Dave Curtis Phondo Sr.
Sujoy Phookan, M.D.
Physician Assistant Surgical Services, Inc
Physicians Resources LLC

All providers in Carmel, IN · Physical Therapy Assistant in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.