MEDICARE: KELSEY JEAN KELLEY OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	9809	NC

General Provider Information

NPI Number	:	1104209600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY JEAN KELLEY OTR/L

Provider Business Mailing Address
First Line	:	9240 CAMERON WOOD DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-7904
Country	:	US
Telephone Number	:	978-807-7558
Fax Number	:

Provider Business Practice Location Address
First Line	:	5113 PIPER STATION DR
Second Line	:	#103
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-6689
Country	:	US
Telephone Number	:	704-752-1616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	09/03/2024

Similar Medicare Providers

1679546451 — DR. STANTON JAMES SMITH M.D.
Practice Location Address:

5113 PIPER STATION DR , SUITE 207
CHARLOTTE, NC
28277-6689

Practice Phone: 704-541-5200
Practice Fax:

1710927611 — MS. CHRISTINA BRONTE FERRI LCSW
Practice Location Address:

5113 PIPER STATION DR , SUITE 207
CHARLOTTE, NC
28277-6689

Practice Phone: 704-541-4242
Practice Fax: 704-541-4244

1467562900 — STACI L MILLER PT
Practice Location Address:

5113 PIPER STATION DR , SUITE 202
CHARLOTTE, NC
28277-6689

Practice Phone: 980-224-8191
Practice Fax: 980-224-8194

1972770345 — MRS. MAMTA N PATEL PT,LMBT
Practice Location Address:

5113 PIPER STATION DR , SUITE 300
CHARLOTTE, NC
28277-6689

Practice Phone: 704-965-4307
Practice Fax:

1164684650 — MRS. JENNY M. HAINES ED.S., ABD
Practice Location Address:

5113 PIPER STATION DR , SUITE 207
CHARLOTTE, NC
28277-6689

Practice Phone: 704-541-0424
Practice Fax: 704-541-4244

1821396557 — FULL MOTION PHYSICAL THERAPY, LLC
Practice Location Address:

5113 PIPER STATION DR , SUITE 202
CHARLOTTE, NC
28277-6689

Practice Phone: 980-224-8191
Practice Fax: 980-224-8194

Directions to “ KELSEY JEAN KELLEY OTR/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.