Individual provider Active NPI

Carla Jane Kelley, PT

  • Physical Medicine & Rehabilitation Physician
  • North Springfield, VT
National Provider Identifier
1427154012
Registry record updated Mar 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0400002086 Issued in VT
Practice address
43 School St
North Springfield, VT 05150-9751
Phone
(802) 886-2321
Fax
(802) 886-2567
NPI assigned
Sep 15, 2006
Last updated
Mar 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2015

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 0400002086 VT Primary

Addresses

Primary practice location

43 School St
North Springfield, VT 05150-9751

Mailing address

43 School St
North Springfield, VT 05150-9751
Phone (802) 886-2321

Other identifiers 5

IdentifierTypeStateIssuer
00005118OtherVTBCBS
212100OtherCIGNA
08Y002456VT01OtherNHANTHEM BCNH
43806OtherVTMOHAWK VALLEY PLAN
VT975501OtherVTMEDICARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0400002086VTMDPhysical Medicine & Rehabilitation Physician

Organizations & group practices 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425772800000",
    "number": "1427154012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SCHOOL ST",
            "city": "NORTH SPRINGFIELD",
            "state": "VT",
            "postal_code": "051509751",
            "telephone_number": "802-886-2321",
            "fax_number": "802-886-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 SCHOOL ST",
            "city": "NORTH SPRINGFIELD",
            "state": "VT",
            "postal_code": "051509751",
            "telephone_number": "802-886-2321",
            "fax_number": "802-886-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CARLA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VT",
            "license": "0400002086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00005118",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "212100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCNH",
            "identifier": "08Y002456VT01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOHAWK VALLEY PLAN",
            "identifier": "43806",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "VT975501",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Springfield, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2015; 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.