Kelly Glasco Poole, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7630 Issued in GA

Practice address

3651 Mars Hill Rd Ste 350a
Watkinsville, GA 30677-8501

Phone

(706) 389-5199

Fax

(706) 723-7081

NPI assigned

May 14, 2007

Last updated

Sep 26, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Sports Rehabilitation Center

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1154409381
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1710193305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 MARS HILL RD STE 350A",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306778501",
            "telephone_number": "706-389-5199",
            "fax_number": "706-723-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 MARS HILL RD STE 350A",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306778501",
            "telephone_number": "706-389-5199",
            "fax_number": "706-723-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "KELLY",
        "middle_name": "GLASCO",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "7630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Ponder
• Dawnell Porcaro, CCC-SLP
• Emerald Porter
• Kelly Foster Posey, CPNP
• Prell Integrative Physical Therapy LLC
• Brian E Prell, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.