Individual provider Active NPI

Kelly Jean Maclain, PT

  • Physical Therapist
  • Southaven, MS
National Provider Identifier
1932455870
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5147 Issued in MS
Practice address
391 Southcrest Cir Ste 205
Southaven, MS 38671-6729
Phone
(901) 259-8401
Fax
(901) 259-2088
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5147 MS Primary

Addresses

Primary practice location

391 Southcrest Cir Ste 205
Southaven, MS 38671-6729

Mailing address

391 Southcrest Cir Ste 205
Southaven, MS 38671-6729
Phone (901) 259-8401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120925000674 MS Practitioner - Physical Therapist in Private Practice 3678722295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Semmes-Murphey Clinic PCGroup PAC ID 1254235914, 66 clinicians

Practice addresses (Care Compare)

391 Southcrest Cir
Suite 205
Southaven, MS 38671-6729
Phone (901) 260-6100

Merit-based Incentive Payment System (MIPS)

Final score
82.8 of 100Reported as group
Quality
67.04
Promoting interoperability
100
Improvement activities
40
Cost
75.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5147MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Semmes-Murphey Clinic PC Physical Therapist CurrentSince Feb 13, 2020 Accepting new patients
Semmes-Murphey Clinic PC Past Accepting new patients
Michael D. Wood, PT, PC Physical Therapist Past Accepting new patients
Columbia Physical Therapy PC Physical Therapist PastSince Jun 1, 2007 Accepting new patients

Locations

391 Southcrest Cir
Ste 205
Southaven, MS 38671
Phone (662) 536-0900

Interoperability endpoints

  • Direct secure messaging: kelly.maclain.1@28653.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1932455870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR STE 205",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716729",
            "telephone_number": "901-259-8401",
            "fax_number": "901-259-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR STE 205",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716729",
            "telephone_number": "901-259-8401",
            "fax_number": "901-259-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLAIN",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "5147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.