Individual provider Active NPI

Matthew Todd Kellum, DPT

  • Physical Therapist
  • Magnolia, TX
National Provider Identifier
1669744454
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1354407 Issued in TX
Practice address
5667 FM 1488 Rd
Magnolia, TX 77354-4299
Phone
(281) 766-0278
NPI assigned
Feb 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH6949 AL
Physical Therapist 225100000X 1354407 TX Primary

Addresses

Primary practice location

5667 FM 1488 Rd
Magnolia, TX 77354-4299

Mailing address

60 Southern Hills Dr
Calera, AL 35040-4824
Phone (717) 409-7910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.04 of 100Reported as group
Quality
90
Improvement activities
40
Cost
71.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH6949ALMDPhysical Therapist
1354407TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bienville Orthopaedic Specialists, LLC Past Accepting new patients
Benchmark Physical Therapy of Alabama, LLC Physical Therapist PastSince Feb 6, 2017 Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1669744454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SOUTHERN HILLS DR",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350404824",
            "telephone_number": "717-409-7910",
            "fax_number": "717-635-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 FM 1488 RD",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773544299",
            "telephone_number": "281-766-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLUM",
        "first_name": "MATTHEW",
        "middle_name": "TODD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH6949",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1354407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.