Active NPI
Kellie Stukel, PHYSICAL THERAPIST
- Physical Therapist
- Gregory, SD
National Provider Identifier
1639530181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1129
- Practice address
- 33609 US Highway 18
Gregory, SD 57533-5070 - Phone
- (605) 830-2446
- NPI assigned
- Mar 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1129 | SD | Primary |
Addresses
Primary practice location
33609 US Highway 18
Gregory, SD 57533-5070
Mailing address
33609 US Highway 18
Gregory, SD 57533-5070
Phone (605) 830-2446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1129 | SD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457654400000",
"number": "1639530181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33609 US HIGHWAY 18",
"city": "GREGORY",
"state": "SD",
"postal_code": "575335070",
"telephone_number": "605-830-2446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33609 US HIGHWAY 18",
"city": "GREGORY",
"state": "SD",
"postal_code": "575335070",
"telephone_number": "605-830-2446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUKEL",
"first_name": "KELLIE",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-11",
"last_updated": "2016-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "1129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gregory, SD
- Raymond G Nemer, M.D.
- Blair Sedlacek, CSW-PIP
- Zachary Sengelmann, ATC
- Silver Threads, Inc. (Silver Threads Assisted Living Center)
- Benjamin Andrew Stukel, DC
- Erin A Tobin, CNP
- Total Renal Care (DaVita Peritoneal Dialysis Program - Gregory)
- Joshua Trede, PT, DPT, CSCS
- Advait Mukul Vasavada, MBBS
- Robert Wik
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.