Kelley Kyburz Mitchell, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

5199 Issued in GA

Practice address

4005 Canton Rd
Marietta, GA 30066-2739

Phone

(770) 728-8833

Fax

(678) 668-7469

NPI assigned

Dec 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Big Gym Therapy, LLC

  • Pediatric Physical Therapist
  • Marietta, GA
  • NPI 1710322706
  NPD
• Kool Kidz Inc

  • Pediatric Physical Therapist
  • Marietta, GA
  • NPI 1134386337
  NPD (past)

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1861551640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662739",
            "telephone_number": "770-728-8833",
            "fax_number": "678-668-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662739",
            "telephone_number": "770-728-8833",
            "fax_number": "678-668-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KELLEY",
        "middle_name": "KYBURZ",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "5199",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "5199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "5199",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Vanessa Miralles, DNP, APRN
• Maria Miranda, RBT
• Absar Ahmad Mirza, MD
• Mohid Mirza
• Sarika Mishra, NP
• Kyle Darren Mitchell, D.O.
• Leia Mitchell, PA-C
• Marylee Mitchell, REGISTERED NURSE
• Mercedes Mitchell, LPC, NCC
• Paul G Mitchell, MD

• Pediatric Physical Therapist in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.