Active NPI
Karla Kelly, PT
- Physical Therapist
- Johns Island, SC
National Provider Identifier
1689306706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10747
- Practice address
- 5009 Gum Tree LN
Johns Island, SC 29455-3501 - Phone
- (843) 560-2305
- NPI assigned
- Jun 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | LPT-31613 | AZ | |
| Physical Therapist | 225100000X | 10747 | SC | Primary |
Addresses
Primary practice location
5009 Gum Tree LN
Johns Island, SC 29455-3501
Mailing address
5009 Gum Tree LN
Johns Island, SC 29455-3501
Phone (843) 560-2305
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 |
|---|---|---|---|
| 10747 | SC | MD | Professional Counselor |
| LPT-31613 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1689306706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5009 GUM TREE LN",
"city": "JOHNS ISLAND",
"state": "SC",
"postal_code": "294553501",
"telephone_number": "843-560-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5009 GUM TREE LN",
"city": "JOHNS ISLAND",
"state": "SC",
"postal_code": "294553501",
"telephone_number": "843-560-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KARLA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-28",
"last_updated": "2022-06-28",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-31613",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "10747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.