Individual provider Active NPI

Kelly L Scollon-Grieve, MD

  • Physical Medicine & Rehabilitation Physician
  • Havertown, PA
National Provider Identifier
1417118506
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD441928 Issued in PA
Practice address
525 West Chester Pike
Suite 203
Havertown, PA 19083
Phone
(610) 789-7767
Fax
(610) 789-7768
NPI assigned
Jun 20, 2008
Last updated
Jul 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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 MD441928 PA Primary

Addresses

Primary practice location

525 West Chester Pike
Suite 203
Havertown, PA 19083

Mailing address

525 West Chester Pike
Suite 203
Havertown, PA 19083
Phone (610) 789-7767

Other names 1

  • Kelly Lynn Scollon Grieve Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110816000704 PA Practitioner - Physical Medicine and Rehabilitation 2769651330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates LTD CurrentSince Jul 5, 2011 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates, LTD Physical Medicine & Rehabilitation CurrentSince Jul 5, 2011 Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

525 W Chester Pike
Ste 203
Havertown, PA 19083
Phone (610) 789-1425

676 E Swedesford Rd
Ste 170
Wayne, PA 19087
Phone (484) 585-4515

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1417118506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WEST CHESTER PIKE",
            "address_2": "SUITE 203",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "19083",
            "telephone_number": "610-789-7767",
            "fax_number": "610-789-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WEST CHESTER PIKE",
            "address_2": "SUITE 203",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "19083",
            "telephone_number": "610-789-7767",
            "fax_number": "610-789-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOLLON-GRIEVE",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD441928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SCOLLON GRIEVE",
            "middle_name": "LYNN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Havertown, PA

Sources for this page

Verify at the official NPI Registry.