Kelly Carter

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016917 Issued in MI

Practice address

286 Hoover Blvd
Holland, MI 49423-3719

Phone

(616) 392-2172

Fax

(616) 392-1726

NPI assigned

Jun 8, 2015

Sex

Female

Sole proprietor

No

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 MI

Enrollment records 1

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1861872533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-392-2172",
            "fax_number": "616-392-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-392-2172",
            "fax_number": "616-392-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee N Carr, LMSW
• Korin Carr
• Matthew David Carr, M.D.
• Jeff Carroll, PHD
• Gracyn Carter
• Kevin S Cassar, OD
• Lesli A Casten, MD
• Stephanie Castilleja
• Angela Joy Castillo
• Yazmin Guadalupe Castillo

• Physical Therapist in Holland, MI
• Providers in Holland, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.