Active NPI
Jessica Marie Kellough, P.T.
- Physical Therapist
- Delaware, OH
National Provider Identifier
1811194087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-10744
- Practice address
- 2270 Warrensburg Rd
Delaware, OH 43015-1336 - Phone
- (740) 369-9614
- Fax
- (740) 363-5881
- NPI assigned
- Jun 29, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-10744 | OH | Primary |
Addresses
Primary practice location
2270 Warrensburg Rd
Delaware, OH 43015-1336
Mailing address
638 Village Mill Dr
Sunbury, OH 43074-9393
Phone (740) 965-1737
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-10744 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811194087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "638 VILLAGE MILL DR",
"city": "SUNBURY",
"state": "OH",
"postal_code": "430749393",
"telephone_number": "740-965-1737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2270 WARRENSBURG RD",
"city": "DELAWARE",
"state": "OH",
"postal_code": "430151336",
"telephone_number": "740-369-9614",
"fax_number": "740-363-5881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLOUGH",
"first_name": "JESSICA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT-10744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delaware, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.