Kelli Jean Kenser, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7488 Issued in ID

Practice address

740 McKinley Ave
Kellogg, ID 83837-2693

Phone

(208) 783-3015

NPI assigned

Feb 10, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shellman Inc PA 45 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 and National Provider Directory roles.

• Shellman Inc PA

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1326050253

  ID, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1548075443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 N LAKEWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142634",
            "telephone_number": "208-783-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MCKINLEY AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372693",
            "telephone_number": "208-783-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENSER",
        "first_name": "KELLI",
        "middle_name": "JEAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Dept of Health & Welfare Reg 1 Amh PSR Kellogg
• John M McNulty MD PC
• Kellog of Cascadia, LLC
• Kellogg Drugs LLC
• Kellogg Physical Therapy Inc
• Kindred Nursing Centers West, LLC
• Kohal Pharmacy Inc
• Kohal Pharmacy Inc
• Jocelyn J Korasick, MD
• Benjamin Collins Krasin, M.D.

• All providers in Kellogg, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.