Individual provider Active NPI

Kelli Mitchell, DPT

  • Physical Therapist
  • East Bridgewater, MA
National Provider Identifier
1760247779
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9057 Issued in MA
Practice address
650 Plymouth St Ste 3
East Bridgewater, MA 02333-2054
Phone
(508) 378-4035
NPI assigned
Feb 19, 2024
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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 9057 MA Primary

Addresses

Primary practice location

650 Plymouth St Ste 3
East Bridgewater, MA 02333-2054

Mailing address

650 Plymouth St Ste 3
East Bridgewater, MA 02333-2054
Phone (508) 378-4035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040511000881 MA Practitioner - Physical Therapist in Private Practice 7214926583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Sports Physical Therapy IncGroup PAC ID 3072593300, 8 clinicians

Practice addresses (Care Compare)

650 Plymouth St
East Bridgewater, MA 02333-2054
Phone (508) 378-4035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Physical Therapy Inc Physical Therapist CurrentSince Mar 2, 2024 Accepting new patients
Orthopedic & Sports Physical Therapy , Inc Physical Therapist CurrentSince Mar 2, 2024 Accepting new patients

Locations

320 Main St
Brockton, MA 02301
Phone (508) 583-2155

650 Plymouth St
Ste 3
East Bridgewater, MA 02333
Phone (508) 378-4035

650 Plymouth St
East Bridgewtr, MA 02333
Phone (508) 378-4035

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1760247779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PLYMOUTH ST STE 3",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023332054",
            "telephone_number": "508-378-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PLYMOUTH ST STE 3",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023332054",
            "telephone_number": "508-378-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KELLI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "9057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Bridgewater, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.