Kelli Block

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016161 Issued in GA

Practice address

2300 Liam Ave Ste 104
Dacula, GA 30019-2265

Phone

(470) 294-0052

NPI assigned

Aug 19, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soar Physical Therapy, IncGroup PAC ID 0941365100, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.79 of 100Reported as group

Quality

82.48

Improvement activities

40

Cost

79.32

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Soar Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Woodstock, GA
  • NPI 1083861785

  GA

  Medicare reassignment Care Compare group NPD
• Fyz 400 LLC

  • Physical Therapy Clinic/Center
  • Cumming, GA
  • NPI 1912622960

  GA

  Medicare reassignment NPD
• Northeast Georgia Rehabilitation Center,Inc

  • Physical Therapy Clinic/Center
  • Royston, GA
  • NPI 1821008087
  NPD (past)

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1841918372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CANDLER WAY",
            "city": "WILLIAMSON",
            "state": "GA",
            "postal_code": "302923284",
            "telephone_number": "678-577-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LIAM AVE STE 104",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192265",
            "telephone_number": "470-294-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "KELLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Douglas Biron, C.S.A
• Bizzie Transportation, LLC
• Chyan A. Black
• Erin F Black
• Daron Blankenship, PT, DPT
• Blue Genesis Holdings LLC
• Desiree M Blunt
• Marguerite Bonnet, PHD, LPC
• Rebecca Lynn Born, LCSW
• Alicia Boyd

• Physical Therapist in Dacula, GA
• Providers in Dacula, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.