Kellianne Josephsen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01671700 Issued in NJ

Practice address

177 Valley St
South Orange, NJ 07079-2836

Phone

(973) 761-0077

NPI assigned

Sep 20, 2016

Last updated

Nov 21, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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 NJ

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Orange Chiropractic Center

  • Chiropractor
  • South Orange, NJ
  • NPI 1669612628
  Medicare reassignment NPD
• Dr. Coach Kelli Physical Therapy

  • Physical Therapy Clinic/Center
  • West Caldwell, NJ
  • NPI 1457822520
  NPD Authorized official

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1558819581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 RUNNYMEDE RD",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070068117",
            "telephone_number": "201-396-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 VALLEY ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792836",
            "telephone_number": "973-761-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPHSEN",
        "first_name": "KELLIANNE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01671700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Darnell Johnson, DDS
• Melissa Marie Johnson, MA, LPC, NCC, ATR
• Natashia Johnson
• Rashaneegon Johnson, LPC
• Jasmine Joseph, PA-C
• Jeffrey Neil Kaplan, D.P.M.
• Arlene Kappraff, LCSW
• Toby Breitstein Kaufman, PH.D.
• Kids Docs,PC
• Kidzdoc MD Pediatrics LLC (Pediatrics on Prospect)

• Physical Therapist in South Orange, NJ
• Providers in South Orange, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.