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

Kellie Jean Carpenter

Individual provider Physical Therapist · NPI 1114420049

Kellie Jean Carpenter is a Physical Therapist in Private Practice in Montvale, New Jersey. Qualified in 2017, 9 years ago. Practices with Sportscare of America, PC, a 132-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
9
Licensed in
NJ
In the registry since
2018
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

221 W Grand Ave
Montvale, NJ 07645-1729
Phone: (201) 307-9209
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA01779100 (NJ)

Record details

NPI number1114420049
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 16, 2018
Last updated in NPPESMarch 16, 2018
Mailing address34 Woodmere Ln, Tenafly, NJ 07670-1923

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Sportscare Of America, Pc — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Montvale