Kristin Marie Kelly, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011100 Issued in MI

Practice address

8481 Holly Rd
Grand Blanc, MI 48439-1812

Phone

(810) 694-1711

NPI assigned

Sep 24, 2013

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

Other names 1

• Ms. Kristin Marie Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1922434836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8481 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391812",
            "telephone_number": "810-694-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8481 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391812",
            "telephone_number": "810-694-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KELLY",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Thomas Keely, RN
• Elissa Keller
• Teresa Lynn Keller, PTA
• Kellogg Speech Language Learning Services
• Kathryn Kellogg
• Theresa Waurzyniak Kelly, LMSW
• Veronica Kelly, M.A.
• Nicole Kemp
• Anne Elise Kender, DPT
• Seaera Sueann Kennedy

• Physical Therapist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.