Individual provider Active NPI

Kellie Marie Stone, PT, DPT

  • Physical Therapist
  • Mount Juliet, TN
National Provider Identifier
1568706679
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14677 Issued in TN
Practice address
11060 Lebanon Road
Mt. Juliet, TN 37122
Phone
(615) 288-7912
Fax
(615) 288-7913
NPI assigned
Nov 15, 2012
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2764 NV
Physical Therapist 225100000X 14677 TN Primary

Addresses

Primary practice location

11060 Lebanon Road
Mt. Juliet, TN 37122

Mailing address

11060 Lebanon Road
Mt. Juliet, TN 37122
Phone (615) 288-7912

Other practice location 1

9080 W Cheyenne Ave Ste 150
Las Vegas, NV 89129-8938
Phone (702) 880-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230427001399 TN Practitioner - Physical Therapist in Private Practice 1456503424 Reassigns benefits to 1 organization
I20260222000117 FL Practitioner - Physical Therapist in Private Practice 1456503424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1905 Clint Moore Rd
Boca Raton, FL 33496-2664

520 Orton Ave
Fort Lauderdale, FL 33304-4073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 20, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 20, 2023 Accepting new patients
Physical Therapy by Design LLC Physical Therapist CurrentSince Jan 13, 2026 Accepting new patients
Werner Institute of Balance & Dizziness Inc Physical Therapist Past Accepting new patients

Locations

1905 Clint Moore Rd
Ste 305
Boca Raton, FL 33496
Phone (561) 208-5515

10151 Entrprs Cntr Blvd
Ste 104
Boynton Beach, FL 33437
Phone (561) 572-3220

Organizations & group practices 4

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": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1568706679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11060 LEBANON ROAD",
            "city": "MT. JULIET",
            "state": "TN",
            "postal_code": "37122",
            "telephone_number": "615-288-7912",
            "fax_number": "615-288-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11060 LEBANON ROAD",
            "city": "MT. JULIET",
            "state": "TN",
            "postal_code": "37122",
            "telephone_number": "615-288-7912",
            "fax_number": "615-288-7913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9080 W Cheyenne Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891298938",
            "country_code": "US",
            "telephone_number": "702-880-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "KELLIE",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2764",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.