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

Miss. Mallory A. Kelly, PT, DPT

Individual provider Physical Therapist · NPI 1104340769

Miss. Mallory A. Kelly, PT, DPT is a Physical Therapist in Private Practice in Twin Lakes, Wisconsin. Qualified in 2017, 9 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
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

700 N Lake Ave
Twin Lakes, WI 53181-9436
Phone: (262) 877-2124
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 543 Orchard St, Antioch, IL 60002-3107 — (847) 395-6100

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1104340769
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedJuly 26, 2017
Last updated in NPPESOctober 3, 2025
Certification dateOctober 3, 2025

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 Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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