Active NPI
Bobbi Kelton
- Physical Therapist
- Princeton, MN
National Provider Identifier
1710369541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- A1618
- Practice address
- 13117 314TH Ave NW
Princeton, MN 55371-3405 - Phone
- (763) 482-1309
- NPI assigned
- Jun 29, 2015
- Last updated
- Jun 29, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | A1618 | MN | Primary |
Addresses
Primary practice location
13117 314TH Ave NW
Princeton, MN 55371-3405
Mailing address
13117 314TH Ave NW
Princeton, MN 55371-3405
Phone (763) 482-1309
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 |
|---|---|---|---|
| A1618 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435536000000",
"number": "1710369541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13117 314TH AVE NW",
"city": "PRINCETON",
"state": "MN",
"postal_code": "553713405",
"telephone_number": "763-482-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13117 314TH AVE NW",
"city": "PRINCETON",
"state": "MN",
"postal_code": "553713405",
"telephone_number": "763-482-1309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELTON",
"first_name": "BOBBI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-29",
"last_updated": "2015-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "A1618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.