Kelly Stueber, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01814400 Issued in NJ

Practice address

76 W Jimmie Leeds Rd Ste 401
Galloway, NJ 08205-9400

Phone

(609) 748-5193

Fax

(856) 748-5197

NPI assigned

Sep 11, 2018

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

Other names 1

• Kelly Massey Former name

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 and National Provider Directory roles.

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment NPD
• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ

  Medicare reassignment NPD
• Ivyrehab Network Inc

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1861623753
  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1619450111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 W JIMMIE LEEDS RD STE 401",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059400",
            "telephone_number": "609-748-5193",
            "fax_number": "097-485-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 W JIMMIE LEEDS RD STE 401",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059400",
            "telephone_number": "609-748-5193",
            "fax_number": "856-748-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUEBER",
        "first_name": "KELLY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01814400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MASSEY",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Celena Storck-Martinez, LCSW
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• Nancy E Sudol, ANPC
• Robert Russell Sudol, MD
• Sure Hearing Services, LLC
• Alexander Swankoski, LAC
• Sean Anthony Swisher, PHARMD.

• Physical Therapist in Galloway, NJ
• Providers in Galloway, 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 Sep 24, 2020; 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.