Individual provider Active NPI

Kelli Rose Palmer, PT

  • Physical Therapist
  • Matthews, NC
National Provider Identifier
1730190083
Registry record updated Jul 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10170 Issued in NC
Practice address
710 Park Center Dr Ste 200
Matthews, NC 28105-5082
Phone
(704) 774-0751
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10170 NC Primary

Addresses

Primary practice location

710 Park Center Dr Ste 200
Matthews, NC 28105-5082

Mailing address

710 Park Center Dr Ste 200
Matthews, NC 28105-5082
Phone (704) 774-0751

Other names 1

  • Kelli Jantzi Tryon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180426000905 NC Practitioner - Physical Therapist in Private Practice 4183988231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10170NCMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Physical Therapist CurrentSince Mar 19, 2018 Accepting new patients
Orthocarolina Physical Therapist CurrentSince Mar 19, 2018 Accepting new patients

Locations

3541 Randolph Rd
Ste 100W
Charlotte, NC 28211
Phone (704) 323-2500

5935 Carnegie Blvd
Ste 104
Charlotte, NC 28209
Phone (704) 323-2500

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

710 Park Center Dr
Ste 200
Matthews, NC 28105
Phone (704) 323-2500

Organizations & group practices 2

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784419200000",
    "number": "1730190083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 PARK CENTER DR STE 200",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055082",
            "telephone_number": "704-774-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PARK CENTER DR STE 200",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055082",
            "telephone_number": "704-774-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KELLI",
        "middle_name": "ROSE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2026-07-19",
        "certification_date": "2026-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "10170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "TRYON",
            "middle_name": "JANTZI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.