Individual provider Active NPI

Kelly Shea Lane, DPT

  • Physical Therapist
  • Bellevue, NE
National Provider Identifier
1740704535
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3770 Issued in NE
Practice address
1702 Hillcrest Dr
Bellevue, NE 68005-3652
Phone
(402) 291-8500
NPI assigned
Aug 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2017

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 3770 NE Primary

Addresses

Primary practice location

1702 Hillcrest Dr
Bellevue, NE 68005-3652

Mailing address

106 Gregg PL
Bellevue, NE 68005-4950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731002428 NE Practitioner - Physical Therapist in Private Practice 0446797013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Key Rehabilitation IncGroup PAC ID 9638086432, 59 clinicians

Practice addresses (Care Compare)

801 N Adams St
Papillion, NE 68046-4310
Phone (888) 362-8704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3770NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Key Rehabilitation Inc CurrentSince May 25, 2024 Accepting new patients
Key Rehabilitation, Inc CurrentSince May 25, 2024 Accepting new patients

Locations

801 N Adams St
Papillion, NE 68046
Phone (402) 339-1775

1335 NW Broad St
Murfreesboro, TN 37129
Phone (615) 983-0240

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1740704535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 GREGG PL",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680054950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 HILLCREST DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053652",
            "telephone_number": "402-291-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KELLY",
        "middle_name": "SHEA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; 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.