Carla Fisher Kelly, P.T.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

03723 Issued in LA

Practice address

104 Oak Aly
Mandeville, LA 70471-3062

Phone

(251) 510-4016

NPI assigned

Jun 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1508026311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 OAK ALY",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713062",
            "telephone_number": "251-510-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 OAK ALY",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713062",
            "telephone_number": "251-510-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CARLA",
        "middle_name": "FISHER",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-15",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "LA",
            "license": "03723",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AL",
            "license": "PTH4543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas L Keister Jr., MD
• Suzanne Kelley, M.ED, LPC, NCC
• William Joseph Kelley, M. D.
• Kelly G Burkenstock MD a Professional Medical Corporation
• Brandi Kelly, PHD
• Destiny Kennedy, DPT
• John Kenney
• Melisa Keo, D.C., ATC
• Kathleen Keowen, M.A., CCC/SLP
• Peter Khong, PHARMACIST

• Pediatric Physical Therapist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Pediatric Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.