Kelsey Gerdes

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070028076 Issued in IL

Practice address

628 S Madison St
Lebanon, IL 62254-1743

Phone

(618) 310-3459

NPI assigned

Mar 7, 2024

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

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 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 and National Provider Directory roles.

• Apex Physical Therapy, LLC

  • Specialist
  • Highland, IL
  • NPI 1033166061

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Apex Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Centerton, AR
  • NPI 1710732607

  Physical Therapist

  NPD

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1649038464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 ANGIE ST",
            "city": "BARTELSO",
            "state": "IL",
            "postal_code": "622181460",
            "telephone_number": "618-971-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 S MADISON ST",
            "city": "LEBANON",
            "state": "IL",
            "postal_code": "622541743",
            "telephone_number": "618-310-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDES",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evercare of Lebanon LLC
• Dale A Fischer, DC
• Jacob Eldon Frazier, DMD, MS
• Tonya Gass
• Katy Renee Gayford, ATC, PHD
• Meagan Elise Graul, DMD
• Justin Groennert, O.D.
• Jill Lynn Groom
• Dawn M. Hankins, PHD, ATC
• Jessica L Henderson, ATC

• Physical Therapist in Lebanon, IL
• Providers in Lebanon, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.