Individual provider Active NPI

Kristin Kern, D.P.T.

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1013295369
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 26405 Issued in FL
Practice address
1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568
Phone
(904) 858-7045
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 26405 FL Primary

Addresses

Primary practice location

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568

Mailing address

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568
Phone (904) 858-7045

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

LicenseStateTypeSpecialty
PT 26405FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1013295369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "KRISTIN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 26405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.