Active NPI
Kolton Reeverts, DPT
- Physical Therapist
- Princeton, IL
National Provider Identifier
1003437781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.022831
- Practice address
- 200 Ace Rd Ste 2
Princeton, IL 61356-8644 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- May 4, 2020
- 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 | 070.022831 | IL | Primary |
Addresses
Primary practice location
200 Ace Rd Ste 2
Princeton, IL 61356-8644
Mailing address
2547 Plainfield Naperville Rd Ste 152
Naperville, IL 60564-8701
Phone (800) 974-4378
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.022831 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588550400000",
"number": "1003437781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2547 PLAINFIELD NAPERVILLE RD STE 152",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605648701",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ACE RD STE 2",
"city": "PRINCETON",
"state": "IL",
"postal_code": "613568644",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEVERTS",
"first_name": "KOLTON",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-04",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.022831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, IL
- Princeton Prompt Care LLC
- Princeton TWP High SCH Dis 500
- Timothy J Puhr, DDS
- Antonio Maria Ramirez, M.D.
- Cynthia Rebholz
- Angela Reidner, RN, MS, CNM
- Residential Alternatives of Illinois Inc (Hawthorne Inn of Princeton)
- Residential Alternatives of Illinois Inc (Manor Court of Princeton)
- Heather Lee Reynolds, D.D.S.
- Rebekka J Root, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.