Individual provider Active NPI

Kelly M. Mull, DPT

  • Physical Therapist
  • Mechanicsburg, PA
National Provider Identifier
1538328307
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4910 Ritter Rd
Mechanicsburg, PA 17055-4891
Phone
(123) 456-7890
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X PT019028 PA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4910 Ritter Rd
Mechanicsburg, PA 17055-4891

Mailing address

5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648
Phone (800) 232-3550

Other names 1

  • Ms. Kelly M. Ahart Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT019028PAMDOccupational Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1538328307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "800-232-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 RITTER RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554891",
            "telephone_number": "123-456-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULL",
        "first_name": "KELLY",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "PA",
            "license": "PT019028",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "AHART",
            "middle_name": "M.",
            "prefix": "MS.",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.