Active NPI
Emily Kelso, PT, DPT
- Physical Therapist
- Cedar Park, TX
National Provider Identifier
1871726216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1191075
- Practice address
- 1401 Medical Pkwy Ste 101
Cedar Park, TX 78613-5012 - Phone
- (512) 248-2200
- Fax
- (512) 260-1991
- NPI assigned
- Sep 2, 2009
- Last updated
- Nov 1, 2021
- 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 | 1191075 | TX | Primary |
Addresses
Primary practice location
1401 Medical Pkwy Ste 101
Cedar Park, TX 78613-5012
Mailing address
8240 N Mopac Expy Ste 100
Austin, TX 78759-8869
Phone (512) 687-1950
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1191075 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeanice Amy Mitchell | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1871726216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8240 N MOPAC EXPY STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598869",
"telephone_number": "512-687-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 MEDICAL PKWY STE 101",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786135012",
"telephone_number": "512-248-2200",
"fax_number": "512-260-1991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELSO",
"first_name": "EMILY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-02",
"last_updated": "2021-11-01",
"certification_date": "2021-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1191075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.