Individual provider Active NPI

Nancy Kelly, PT

  • Physical Therapist
  • North Canton, OH
National Provider Identifier
1558694778
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 4462 Issued in OH
Practice address
7233 Whipple Ave NW
North Canton, OH 44720-7137
Phone
(330) 498-8200
NPI assigned
Sep 8, 2009
Last updated
Sep 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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 PT 4462 OH Primary

Addresses

Primary practice location

7233 Whipple Ave NW
North Canton, OH 44720-7137

Mailing address

5333 Waterloo Rd
Atwater, OH 44201-9108
Phone (330) 947-2034

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621002042 OH Practitioner - Physical Therapist in Private Practice 4284177908 Reassigns benefits to 1 organization
Practice locations: Ravenna, OH

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluechip Initiative IncGroup PAC ID 7315937760, 3 clinicians

Practice addresses (Care Compare)

6693 N Chestnut St
Ravenna, OH 44266-3900
Phone (330) 297-9797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 4462OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bluechip Initiative Inc CurrentSince Mar 16, 2024 Accepting new patients

Locations

6693 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-6014

6693 N Chestnut St
Ste 128
Ravenna, OH 44266
Phone (330) 297-9797

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1558694778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 WATERLOO RD",
            "city": "ATWATER",
            "state": "OH",
            "postal_code": "442019108",
            "telephone_number": "330-947-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7233 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207137",
            "telephone_number": "330-498-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "NANCY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 4462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.