Active NPI
Kevin Scott Soto, PT
- Physical Therapist
- Evans, GA
National Provider Identifier
1013521269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014932
- Practice address
- 400 Town Park Blvd Ste 100
Evans, GA 30809-3515 - Phone
- (706) 854-9850
- NPI assigned
- Sep 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 | PT014932 | GA | Primary |
Addresses
Primary practice location
400 Town Park Blvd Ste 100
Evans, GA 30809-3515
Mailing address
309 Nesbitt Rd
Leesburg, GA 31763-3542
Phone (229) 291-3500
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 |
|---|---|---|---|
| PT014932 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602460800000",
"number": "1013521269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 NESBITT RD",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317633542",
"telephone_number": "229-291-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 TOWN PARK BLVD STE 100",
"city": "EVANS",
"state": "GA",
"postal_code": "308093515",
"telephone_number": "706-854-9850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "KEVIN",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-04",
"last_updated": "2020-10-12",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT014932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
- Stanley T Smith Jr., M.D.
- Stephen Michael Smith, RN, SRNA
- SNH Georgia Tenant LLC
- Solara Integrative Therapy LLC
- Victor Alejandro Soto Velazquez
- Southeast Surgical Assistants, LLC
- Southeastern Aesthetic Surgery, LLC
- Southeastern Medical Brokers, Inc.
- Southern Anesthesia Service
- Southern Oaks Counseling, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.