Kelly Rae Santine Landry, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2207 Issued in MS

Practice address

4063 Ginger Dr
Suite C
Diberville, MS 39540-3705

Phone

(228) 354-0093

Fax

(228) 354-0094

NPI assigned

Apr 10, 2007

Last updated

Mar 12, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Therapy Solutions LLC

  dba Advanced Therapy

  • Physical Therapy Clinic/Center
  • D'Iberville, MS
  • NPI 1164797973
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1396868568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4063 GINGER DR",
            "address_2": "SUITE C",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395403705",
            "telephone_number": "228-354-0093",
            "fax_number": "228-354-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 GINGER DR",
            "address_2": "SUITE C",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395403705",
            "telephone_number": "228-354-0093",
            "fax_number": "228-354-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTINE LANDRY",
        "first_name": "KELLY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121391",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saad Medical Management, Inc (Saad Home Nursing Services of MS)
• Saad Medical Management, Inc. (Saad Hospice Services of MS)
• Herman Marx Sacks, D.O.
• Katherine Lynne Sanders, O.D.
• Shayna Sanders
• Farrah Schonewitz
• Scripts, LLC
• Tiffany Ann Seal, PTA
• Doreen Shoemake
• Mary L Simmons

• Physical Therapist in D'Iberville, MS
• Providers in D'Iberville, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.