Individual provider Active NPI

Kelly Mortellite, D.P.T.

  • Physical Therapist
  • Loveland, CO
National Provider Identifier
1740412709
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10512 Issued in CO
Practice address
725 E 4TH St
Loveland, CO 80537-5731
Phone
(970) 391-8647
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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 10512 CO Primary

Addresses

Primary practice location

725 E 4TH St
Loveland, CO 80537-5731

Mailing address

725 E 4TH St
Loveland, CO 80537-5731
Phone (970) 391-8647

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10512COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1740412709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E 4TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375731",
            "telephone_number": "970-391-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E 4TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375731",
            "telephone_number": "970-391-8647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTELLITE",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "10512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.