Kelly Kopp Gayles, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009644 Issued in GA

Practice address

24 E. Crossville Rd.
Suite 150
Roswell, GA 30075

Phone

(678) 822-0721

Fax

(678) 822-0724

NPI assigned

Aug 17, 2007

Last updated

Feb 13, 2012By 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 2

Addresses

Other names 1

• Miss Kelly Nicole Kopp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1689866212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 E. CROSSVILLE RD.",
            "address_2": "SUITE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30075",
            "telephone_number": "678-822-0721",
            "fax_number": "678-822-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E. CROSSVILLE RD.",
            "address_2": "SUITE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30075",
            "telephone_number": "678-822-0721",
            "fax_number": "678-822-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLES",
        "first_name": "KELLY",
        "middle_name": "KOPP",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.016003",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KOPP",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Buterbaugh Gay, MD
• Katherine Lee Gay, PT, DPT
• Mary F Gay, PHD
• Nicola Simone Gay, COTA/L
• Kimberly Joyce Gayda, RBT
• Gazal Eyecare
• Alexander Gebhardt, DC
• Jamie Elizabeth George, LPMT, MT-BC
• Melissa George, PTA
• Georgia Chiropractic Neurology Center LLC

• Physical Therapist in Roswell, GA
• Providers in Roswell, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.