Kelly Boss

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P19369 Issued in NC

Practice address

2630 E 7TH St Ste 206
Charlotte, NC 28204-4319

Phone

(704) 333-1052

Fax

(704) 333-1054

NPI assigned

May 27, 2020

Last updated

May 27, 2020By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Physical Therapy LLCGroup PAC ID 0840388666, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Elite Physical Therapy LLC

  • Physical Therapist
  • Charlotte, NC
  • NPI 1104926419
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1639792401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-333-1052",
            "fax_number": "704-333-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-333-1052",
            "fax_number": "704-333-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSS",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elitept1@eliteptone.com",
            "affiliation": "N",
            "address_1": "2630 E 7th St Ste 206",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282044319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joan Bose, RNFA
• Clarence W. Boshamer, LPC
• Boslap, LLC
• Boss Counseling and Consulting LLC
• Aliya Sabriya Boss, LCSW
• Dylan Michael Bossard, DNP, FNP-C
• Michael Bosse, MD
• Jillian Nunn Bossemeyer, MS, CAS, LPA
• Bossolina DDS PLLC (Center City Dental)
• Michael J Bossolina Jr., DDS

• Physical Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.