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

Kelly Jean Desselle, PT, DPT, ATC

Individual provider Physical Therapist · NPI 1366285116

Kelly Jean Desselle, PT, DPT, ATC is a Physical Therapist in Private Practice in Grain Valley, Missouri. Qualified in 2024, 2 years ago. Practices with Upward Physical Therapy LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
2
Licensed in
MO
In the registry since
2024
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.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1207 NW Pamela Blvd
Grain Valley, MO 64029-7844
Phone: (816) 867-6022
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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 2025021797 (MO)

Record details

NPI number1366285116
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT , ATC
Sole proprietorNo
NPI enumeratedJune 18, 2024
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Upward Physical Therapy Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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