Kelby R. Church, PT, DPT, OCS, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 002702 Issued in WV

Practice address

174 N State Route 2 Ste 2
New Martinsville, WV 26155-1604

Phone

(304) 447-6778

Fax

(304) 447-6779

NPI assigned

Jul 30, 2008

Last updated

Dec 29, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain River Physical Therapy Specialists LLCGroup PAC ID 1759795834, shared by 3 NPIs, 22 clinicians

Practice addresses (Care Compare)

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.

• Mountain River Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Parkersburg, WV
  • NPI 1487668794

  Physical Therapist

  Medicare reassignment NPD
• Mountain River Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Parkersburg, WV
  • NPI 1437754157

  Physical Therapist

  Medicare reassignment NPD
• Mountain River Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Vincent, OH
  • NPI 1801491568

  Physical Therapist

  Medicare reassignment NPD
• Mountain River Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Parkersburg, WV
  • NPI 1154555241
  NPD
• Mountain River Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Ocala, FL
  • NPI 1528663283

  Physical Therapist

  NPD
• Morgantown Physical Therapy Associates, Inc.

  dba HealthWorks Rehab and Fitness

  • Physical Therapist
  • Morgantown, WV
  • NPI 1437191756
  NPD (past)
• Morgantown Physical Therapy Associates, Inc.

  dba HealthWorks Rehab and Fitness

  • Durable Medical Equipment & Medical Supplies
  • Morgantown, WV
  • NPI 1922486026
  NPD (past)
• Mountain River Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • New Martinsville, WV
  • NPI 1710182274
  NPD (past)

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1639335540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST STE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 N STATE ROUTE 2 STE 2",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261551604",
            "telephone_number": "304-447-6778",
            "fax_number": "304-447-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "KELBY",
        "middle_name": "R.",
        "credential": "PT, DPT, OCS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT 002702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012940",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Stewart Campbell, O.D.
• Shana Campbell, PHARM.D.
• Haylee Rae Carothers
• Carolee Cecil
• Subramaniyam Chandrasekhar, MD
• Tammy Marie Church, PRSS
• Harriet Edna Clark
• Kari K Clark
• Mary Elizabeth Clegg
• Melinda Clinton

• Physical Therapist in New Martinsville, WV
• Providers in New Martinsville, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.