Active NPI
Kimberly Eldridge Bauer, PHYSICAL THERAPIST
- Physical Therapist
- Georgetown, KY
National Provider Identifier
1033223607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 001234
- Practice address
- 1001 Cherry Blossom Way
Toyota
Georgetown, KY 40324-9564 - Phone
- (502) 868-2944
- Fax
- (502) 868-2639
- NPI assigned
- Aug 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | 001234 | KY | Primary |
Addresses
Primary practice location
1001 Cherry Blossom Way
Toyota
Georgetown, KY 40324-9564
Mailing address
1041 E Main St
Frankfort, KY 40601-2548
Phone (502) 695-0931
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 |
|---|---|---|---|
| 001234 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033223607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1041 E MAIN ST",
"city": "FRANKFORT",
"state": "KY",
"postal_code": "406012548",
"telephone_number": "502-695-0931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 CHERRY BLOSSOM WAY",
"address_2": "TOYOTA",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403249564",
"telephone_number": "502-868-2944",
"fax_number": "502-868-2639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "KIMBERLY",
"middle_name": "ELDRIDGE",
"name_prefix": "Ms.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "001234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Georgetown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.