Individual provider Active NPI

Kiersten Flynn, DPT

  • Physical Therapist
  • Clayton, NC
National Provider Identifier
1003104654
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P15498 Issued in NC
Practice address
8838 US Highway 70 W
Suite 300
Clayton, NC 27520-4822
Phone
(919) 550-7722
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 034017 NY
Physical Therapist 225100000X P15498 NC Primary

Addresses

Primary practice location

8838 US Highway 70 W
Suite 300
Clayton, NC 27520-4822

Mailing address

16 Maybrook Rd
Suite C
Campbell Hall, NY 10916-2743
Phone (845) 636-4344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150727002859 NC Practitioner - Physical Therapist in Private Practice 7810166642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports and More Physical Therapy IncGroup PAC ID 4385618594, 13 clinicians

Practice addresses (Care Compare)

8838 US Hwy 70 W
Suite 300
Clayton, NC 27520-4822
Phone (919) 550-7722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034017NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & More Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients

Locations

8838 US Highway 70 W
Ste 300
Clayton, NC 27520
Phone (919) 550-7722

502 McKnight Dr
Ste 103
Knightdale, NC 27545
Phone (919) 217-8885

8300 Health Park
Ste 127
Raleigh, NC 27615
Phone (919) 845-6160

16 Maybrook Rd
Ste D
Campbell Hall, NY 10916

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1003104654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MAYBROOK RD",
            "address_2": "SUITE C",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162743",
            "telephone_number": "845-636-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8838 US HIGHWAY 70 W",
            "address_2": "SUITE 300",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204822",
            "telephone_number": "919-550-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "KIERSTEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034017",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.