KELLIE SUE PECK (NPI# 1932600566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932600566 |
| Entity Type | Individual |
| Full Name | KELLIE SUE PECK |
| Credential | DPT |
| Practice Address |
1200 E Michigan Ave Ste 145 Lansing MI 48912-1897 |
| Practice Telephone | 5173645464 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
5501015694 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1200 E MICHIGAN AVE STE 145 |
| City | LANSING |
| State | MI |
| Zip Code | 48912-1897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568564813 | Maria Jevitz Patterson | Pediatrics | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2006-09-05 |
| 1740802958 | Msu Health Care Inc. | Pediatrics | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2020-05-11 |
| 1730715566 | Msu Health Care Inc | Pediatrics | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2020-03-12 |
| 1912539743 | Msu Health Care Inc. | Allergy & Immunology | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2020-02-10 |
| 1922570811 | Alyssa K Harris | Occupational Therapist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-12-18 |
| 1831661776 | Tonya Ann Taylor | Physical Therapist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-12-17 |
| 1336641471 | Julianna Putman | Speech-Language Pathologist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-03-05 |
| 1104328665 | Kathleen Marie Wilson | Occupational Therapist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-03-01 |
| 1215438841 | Andrea Darlene Evancho | Physical Therapist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-02-28 |
| 1376044982 | Jennifer Lynn Deibel | Occupational Therapist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
| 1568087237 | Ahmed Mohamed Haggag | Student in an Organized Health Care Education/Training Program | 1215 East Michigan Avenue 3rd Floor, Lansing, MI 48912 | 2020-06-09 |
| 1467074773 | Craig Hargurkirat Malli | Family Medicine | 1215 E Michigan Avenue Suite 245, Lansing, MI 48912 | 2020-05-08 |
| 1215558945 | Temmy J. Brotherson | Family Medicine | Sparrow Health Systems, 1200 E Michigan Avenues, Suite 245, Lansing, MI 48912 | 2020-05-05 |
| 1386265452 | Kyle Patrick Doran | Emergency Medicine | Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI 48912 | 2020-04-30 |
| 1316418841 | Andrea Mcswain Do PC | Obstetrics & Gynecology | 1909 E. Michigan Ave, Lansing, MI 48912 | 2018-12-10 |
| 1215386115 | Michael Vernon Hollis | Student in an Organized Health Care Education/Training Program | 1500 E Michigan Ave, Suite 655, Lansing, MI 48912 | 2016-06-10 |
| 1518333970 | Eastside Community Action Center | Social Worker | 1001 Dakin Street, Suite B, Lansing, MI 48912 | 2015-08-19 |
| 1649667403 | Cheryl Ann Wade | Counselor | 1712 E Michigan Ave., Lansing, MI 48912 | 2015-04-20 |
| 1083006134 | Carol Pratt | Occupational Therapist | 1200 E. Michigan Ave, Outpatient Rehab - Lower Level, Lansing, MI 48912 | 2015-02-26 |
| Find all providers in zip 48912 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396002275 | Sheila Littleton | Physical Therapist | 5400 S Pennsylvania Ave Ste 2, Lansing, MI 48911-4049 | 2012-04-18 |
| 1245702760 | Karen Double Barnes | Physical Therapist | 1215 E Michigan Ave, Lansing, MI 48912-1896 | 2018-12-21 |
| 1215438841 | Andrea Darlene Evancho | Physical Therapist | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2018-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225668759 | Michele Lynn Avery | Physical Therapist | 15959 Hall Rd Ste 203, Macomb, MI 48044-5366 | 2020-01-23 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1396247193 | Amy Lynn Casedy | Physical Therapist | 400 E Eisenhower Pkwy Ste A, Ann Arbor, MI 48108-3302 | 2018-03-07 |
| 1588166987 | Christopher Tapley | Physical Therapist | 1540 E Hospital Dr Spc 4236, Ann Arbor, MI 48109-4236 | 2018-03-02 |
| 1639679343 | Jessica Pizzo | Physical Therapist | 15959 Hall Rd Ste 410, Macomb, MI 48044-5365 | 2018-02-19 |
| 1316310402 | Kelsey Michals | Physical Therapist | 42864 Ashbury Dr, Novi, MI 48375-4725 | 2015-11-11 |
| 1093103020 | Maria Margaret Dobbertien | Physical Therapist | 777 Goguac St W Ste B2, Battle Creek, MI 49015-2097 | 2014-12-29 |
| 1316386105 | Sarah Margaret Cardy Goncalves | Physical Therapist | 2672 S. Rochester Rd., Rochester Hills, MI 48307 | 2013-06-14 |
| 1144567520 | Kirsten Etka Hallstrom | Physical Therapist | 1459 Coventry Square Dr, Ann Arbor, MI 48103-6314 | 2013-01-06 |
| 1609112671 | Stacy Lynn Zousmer | Physical Therapist | 4266 Strathdale Ln, West Bloomfield, MI 48323-3143 | 2012-12-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.