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

Mr. Kelly Gerrit Vredeveld, PT, DPT

Individual provider Physical Therapist · NPI 1588602874

Mr. Kelly Gerrit Vredeveld, PT, DPT is registered under Physical Therapist in Private Practice in Prescott Valley, Arizona. Qualified in 2002, 24 years ago. Practices with Canyon Physical Therapy and Aquatic Rehabilitation PLLC, a 4-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
24
Licensed in
AZ
In the registry since
2006
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

2852 N Navajo Dr Ste A
Prescott Valley, AZ 86314-4966
Phone: (928) 772-9797
Fax: (928) 772-9340
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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 5810 (AZ)

Record details

NPI number1588602874
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedJune 2, 2006
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Canyon Physical Therapy And Aquatic Rehabilitation Pllc — 4 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 patients216
Services billed 7,424 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

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 Canyon Physical Therapy and Aquatic Rehabilitation PLLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 4 clinicians in the practice; 2 are shown here.

Other providers in Prescott Valley