Kelly Marie Bufford, PT ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070015713 Issued in IL

Practice address

535 E North St Ste C
Bradley, IL 60915-1188

Phone

(815) 802-7503

Fax

(815) 802-7514

NPI assigned

Jun 12, 2007

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Marie Watt Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Valley Physical Therapy Spine and Joint Center LLCGroup PAC ID 8426133950, 4 clinicians

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.

• River Valley Physical Therapy Spine and Joint Center LLC

  • Physical Therapist
  • Bradley, IL
  • NPI 1144401233
  Medicare reassignment Care Compare group NPD
• Athletic and Therapeutic Institute of Bourbonnais, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Bourbonnais, IL
  • NPI 1861503542
  Medicare reassignment NPD
• Athletic and Therapeutic Institute of Naperville LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Aurora, IL
  • NPI 1023129681
  Medicare reassignment NPD
• Athletic and Therapeutic Institute of Bourbonnais, LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, IL
  • NPI 1124766696

  Physical Therapist

  NPD
• Athletic and Therapeutic Institute of Naperville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hazel Crest, IL
  • NPI 1043952641
  NPD
• Accelerated Rehabilitation Centers LTD

  • Physical Therapist
  • Westmont, IL
  • NPI 1205875713
  NPD (past)
• Accelerated Rehabilitation Centers, LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Roscoe, IL
  • NPI 1043604184
  NPD (past)
• Newsome Rehabilitation Center

  dba Newsome Physical Therapy Network

  • Physical Therapist
  • Channahon, IL
  • NPI 1760544951
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1497959647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 E NORTH ST STE C",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609151188",
            "telephone_number": "815-802-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E NORTH ST STE C",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609151188",
            "telephone_number": "815-802-7503",
            "fax_number": "815-802-7514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 W Main St",
            "address_purpose": "LOCATION",
            "city": "Peotone",
            "state": "IL",
            "postal_code": "604688201",
            "country_code": "US",
            "telephone_number": "708-792-0044",
            "fax_number": "708-792-0043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUFFORD",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PT ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015713",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.001984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WATT",
            "middle_name": "MARIE",
            "credential": "PT ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sophia Boyer
• Bradley Bourbonnais School Distrist 307
• Bradley Royale, Inc.
• Bradley School District #61
• Gerard Breuker, PT, DPT
• Laura H Burkhalter
• Quincy Lee Campbell
• Denise Lynn Cannon, LMT
• Christine Cantrell
• Laura Carpenter, PTA, LMT

• Physical Therapist in Bradley, IL
• Providers in Bradley, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.