Kelley Young Havens, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT22947 Issued in CA

Practice address

Cornerstone Physical Therapy
7145 N. Chestnut Ave. Suite 105
Fresno, CA 93720

Phone

(559) 299-2244

Fax

(559) 299-2487

NPI assigned

Sep 9, 2009

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

• Ms. Kelley Jo Young Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hughes/Brogan Physical TherapyGroup PAC ID 6507754884, 5 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.

• Cornerstone Physical Therapy

  • Physical Therapist
  • Fresno, CA
  • NPI 1528100450
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1669705620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 N. CHESTNUT AVE.",
            "address_2": "SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-999-6147",
            "fax_number": "559-323-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNERSTONE PHYSICAL THERAPY",
            "address_2": "7145 N. CHESTNUT AVE. SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-299-2244",
            "fax_number": "559-299-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "KELLEY",
        "middle_name": "YOUNG",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "YOUNG",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haven Health Partners
• Haven Hills Center LLC
• Haven Medical Group Inc.
• Havens Orthodontics, Inc.
• Bruce Havens, D.D.S
• Gary Havlicek, CRNA
• Carol Lee Havner
• April Renee Hawkins
• Ashlee Nicole Hawkins
• Joseph Buchanan Hawkins Jr., M.D.

• Physical Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.