Active NPI
Kendall Giles
- Physical Therapist
- Mattoon, IL
National Provider Identifier
1003279191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070022050
- Practice address
- 1004 Health Center Dr
Mattoon, IL 61938-9253 - Phone
- (217) 258-2530
- Fax
- (217) 258-4176
- NPI assigned
- Apr 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070022050 | IL | Primary |
Addresses
Primary practice location
1004 Health Center Dr
Mattoon, IL 61938-9253
Mailing address
1004 Health Center Dr
Mattoon, IL 61938-9253
Phone (217) 258-2530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070022050 | Other | IL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070022050 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459814400000",
"number": "1003279191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 HEALTH CENTER DR",
"city": "MATTOON",
"state": "IL",
"postal_code": "619389253",
"telephone_number": "217-258-2530",
"fax_number": "217-258-4176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 HEALTH CENTER DR",
"city": "MATTOON",
"state": "IL",
"postal_code": "619389253",
"telephone_number": "217-258-2530",
"fax_number": "217-258-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILES",
"first_name": "KENDALL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-05",
"last_updated": "2016-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070022050",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "070022050",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.