Individual provider Active NPI

Kelley McCue, PT, DPT

  • Physical Therapist
  • Ludington, MI
National Provider Identifier
1548639735
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
55501016385 Issued in MI
Practice address
3837 W US Highway 10
Ludington, MI 49431-9601
Phone
(231) 674-5815
Fax
(231) 683-4705
NPI assigned
Sep 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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 55501016385 MI Primary

Addresses

Primary practice location

3837 W US Highway 10
Ludington, MI 49431-9601

Mailing address

PO Box 412031
Boston, MA 02241-2031
Phone (914) 294-4050

Other practice location 1

10483 Dixie Hwy
Holly, MI 48442
Phone (810) 771-7686

Other practice location 2

16760 Lincoln St
Grand Haven, MI 49417-8864
Phone (616) 935-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208000518 MI Practitioner - Physical Therapist in Private Practice 1456655760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

1764 S Ortonville Rd
Suite 400
Ortonville, MI 48462-8819
Phone (248) 793-5730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
55501016385MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Level Eleven Howell, LLC CurrentSince Sep 24, 2023 Accepting new patients
Level Eleven Saginaw, LLC CurrentSince Oct 1, 2023 Accepting new patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince May 23, 2024 Accepting new patients

Locations

1030 W Highland Rd
Howell, MI 48843
Phone (517) 546-9000

3837 W US Highway 10
Ludington, MI 49431
Phone (231) 674-5815

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

379 W Western Ave
Ste 101
Muskegon, MI 49440
Phone (231) 845-1906

1764 S Ortonville Rd
Ortonville, MI 48462
Phone (248) 793-5730

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

3856 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 233-4944

5815 Bay Rd
Ste 400
Saginaw, MI 48604
Phone (989) 447-2538

8158 Cooley Lake Rd
White Lake, MI 48386
Phone (248) 956-1894

Organizations & group practices 3

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1548639735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412031",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412031",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3837 W US HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494319601",
            "telephone_number": "231-674-5815",
            "fax_number": "231-683-4705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10483 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Holly",
            "state": "MI",
            "postal_code": "48442",
            "country_code": "US",
            "telephone_number": "810-771-7686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16760 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494178864",
            "country_code": "US",
            "telephone_number": "616-935-3300",
            "fax_number": "616-935-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCUE",
        "first_name": "KELLEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "55501016385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.