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

Nicholas Cameron Kelley, PTDPT

Individual provider Physical Therapist · NPI 1902685449

Nicholas Cameron Kelley, PTDPT is a Physical Therapist in Private Practice in Perris, California. Qualified in 2023, 3 years ago. Practices with All Star Physical Therapy, a 150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

126 Avocado Ave Ste 107
Perris, CA 92571-2605
Phone: (951) 564-3080
Fax: (951) 564-3081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 626b Main St Ste 201, Nashville, TN 37206-3639 — (866) 932-1798

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 304937 (CA)

Record details

NPI number1902685449
Entity typeIndividual (Type 1)
GenderMale
Credentials PTDPT
Sole proprietorNo
NPI enumeratedSeptember 25, 2023
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025
Mailing address24821 Evening Shadow Ct, Moreno Valley, CA 92557-4207

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice All Star Physical Therapy — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Perris