Individual provider Active NPI

Kelly John

  • Physical Therapist
  • Brevard, NC
National Provider Identifier
1801540240
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20951 Issued in NC
Practice address
102 College Station Dr Ste 7
Brevard, NC 28712-3195
Phone
(828) 966-3129
NPI assigned
Feb 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 P20951 NC Primary

Addresses

Primary practice location

102 College Station Dr Ste 7
Brevard, NC 28712-3195

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220331000007 NC Practitioner - Physical Therapist in Private Practice 4385030303 Reassigns benefits to 1 organization
I20241113003303 SC Practitioner - Physical Therapist in Private Practice 4385030303 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of North Carolina, LLCGroup PAC ID 1052609278, 242 clinicians

Practice addresses (Care Compare)

61 Weaver Blvd
Suite 118
Weaverville, NC 28787-9804
Phone (828) 519-9070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20951NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

102 College Station Dr
Ste 7
Brevard, NC 28712
Phone (828) 966-3129

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

61 Weaver Blvd
Ste 118
Weaverville, NC 28787
Phone (828) 519-9070

908 Smithfield Way
Ste 104
Fort Mill, SC 29715
Phone (803) 470-4933

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

Organizations & group practices 8

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": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1801540240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 COLLEGE STATION DR STE 7",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287123195",
            "telephone_number": "828-966-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brevard, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.