Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Jason Kelly, PT, DPT

Individual provider Physical Therapist · NPI 1821301961

Kenneth Jason Kelly, PT, DPT is registered under Physical Therapist in Private Practice in Colonial Heights, Virginia. Qualified in 2010, 16 years ago. Practices with Tidewater Physical Therapy LLC, a 222-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
16
Licensed in
VA
In the registry since
2010
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

300B Temple Lake Dr Ste 1
Colonial Heights, VA 23834-2973
Phone: (804) 524-9036
Fax: (804) 524-9039
Show map & directions

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2305206555 (VA)

Record details

NPI number1821301961
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedJuly 19, 2010
Last updated in NPPESMay 27, 2020
Certification dateMay 27, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Tidewater Physical Therapy Llc — 222 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients286
Services billed 7,872 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Tidewater Physical Therapy LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 222 clinicians in the practice; 12 are shown here.

Other providers in Colonial Heights