Individual provider Active NPI

Kelly M Donaldson, PT

  • Physical Therapist
  • Sandusky, OH
National Provider Identifier
1457794810
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.011508 Issued in OH
Practice address
2500 W Strub Rd Ste 150
Sandusky, OH 44870-5488
Phone
(419) 626-4162
Fax
(419) 626-1268
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT.011508 OH Primary

Addresses

Primary practice location

2500 W Strub Rd Ste 150
Sandusky, OH 44870-5488

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 609-1112

Other practice location 1

339 E Maple St
North Canton, OH 44720-2593
Phone (330) 498-8200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221001591 OH Practitioner - Physical Therapist in Private Practice 8729362652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT.011508OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince Mar 1, 2017 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Mar 1, 2017 Accepting new patients

Locations

112 Independence Way
Ste 170
Clyde, OH 43410
Phone (419) 547-2810

629 Bartson Rd
Ste B
Fremont, OH 43420
Phone (419) 559-2810

164 Milan Ave
Norwalk, OH 44857
Phone (419) 660-0876

2500 W Strub Rd
Ste 150
Sandusky, OH 44870
Phone (419) 626-4162

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1457794810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-609-1112",
            "fax_number": "419-502-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W STRUB RD STE 150",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705488",
            "telephone_number": "419-626-4162",
            "fax_number": "419-626-1268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 E Maple St",
            "address_purpose": "LOCATION",
            "city": "North Canton",
            "state": "OH",
            "postal_code": "447202593",
            "country_code": "US",
            "telephone_number": "330-498-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.011508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.