Individual provider Active NPI

Jordan Denise Kelly, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Exeter, NH
National Provider Identifier
1396461083
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5056 Issued in NH
Practice address
7 Riverwoods Dr
Exeter, NH 03833-4374
Phone
(603) 772-4700
NPI assigned
Oct 14, 2022
Last updated
Oct 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5056 NH Primary

Addresses

Primary practice location

7 Riverwoods Dr
Exeter, NH 03833-4374

Mailing address

180 Woodbury St Apt 710
Manchester, NH 03102-6732
Phone (315) 663-5436

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5056NHMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1396461083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WOODBURY ST APT 710",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031026732",
            "telephone_number": "315-663-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 RIVERWOODS DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334374",
            "telephone_number": "603-772-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JORDAN",
        "middle_name": "DENISE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NH",
            "license": "5056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.