Kelly Carelock, PTA
Individual provider Active NPI Pediatric Rehabilitation Medicine Physician · Elgin, OK
NPI 1831904192 · NPPES record last updated Feb 12, 2025
Key facts
- NPI
- 1831904192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Rehabilitation Medicine Physician 2081P0010X
- License
- 2960 (OK)
- Practice address
- 9201 Ok-17
Suite F
Elgin, OK 73538 - Phone
- (580) 454-9200
- NPI assigned
- Feb 12, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2960 | OK | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2960 | OK | |
| Pediatric Rehabilitation Medicine Physician | 2081P0010X | 2960 | OK | Yes |
Addresses
Primary practice location
9201 Ok-17
Suite F
Elgin, OK 73538
Mailing address
1409 NE Scenic RDG
Elgin, OK 73538-4200
Phone (580) 574-9085
Other providers in Elgin, OK
- Kellen J Allen
- Mercedes Sherrell Anderson
- Brooke Braly
- Stephanie Chambers
- Comanche County Hospital Authority
- Latoya Rashaundra Crosby
- Kimberly Rochelle Dalrymple
- Kalli Davis
All providers in Elgin, OK · Pediatric Rehabilitation Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.