Individual provider Active NPI

Theresa Kelly-Mitchell, DPT, PT, MPH

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1447105622
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP053702T Issued in VA
Practice address
911 B St Ste 102
Chesapeake, VA 23324-2462
Phone
(757) 548-0014
NPI assigned
Mar 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19341 MT
Physical Therapist 225100000X CP053702T VA Primary

Addresses

Primary practice location

911 B St Ste 102
Chesapeake, VA 23324-2462

Mailing address

PO Box 412307
Boston, MA 02241-2307
Phone (914) 294-4050

Other names 1

  • Theresa Leigh Kelly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260324003533 VA Practitioner - Physical Therapist in Private Practice 1658855994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

911 B St
Suite 102
Chesapeake, VA 23324-2462
Phone (757) 548-0014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19341MTMDPhysical Therapist
CP053702TVAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Mar 1, 2026 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist PastSince Mar 1, 2026 Accepting new patients

Locations

911 B St
Ste 102
Chesapeake, VA 23324
Phone (757) 548-0014

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": "1772496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1447105622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 B ST STE 102",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242462",
            "telephone_number": "757-548-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-MITCHELL",
        "first_name": "THERESA",
        "credential": "DPT, PT, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "19341",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP053702T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "KELLY",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.