Individual provider Active NPI

Kristen R Thompson, LPT

  • Physical Therapist
  • Fairview Heights, IL
National Provider Identifier
1063452308
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10607 Lincoln TRL
Fairview Heights, IL 62208-1913
Phone
(618) 310-1600
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 IL Primary

Addresses

Primary practice location

10607 Lincoln TRL
Fairview Heights, IL 62208-1913

Mailing address

9684 Mallard Dr
Mascoutah, IL 62258-2754
Phone (618) 566-8160

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
070014249ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalize Chiropractic: a Creating Wellness Center LLC PastSince Nov 19, 2007 Accepting new patients
Wellnessone of Swansea, LLC Physical Therapist Past Accepting new patients
Wellnessone of Belleville, LLC Physical Therapist Past Accepting new patients
Wellnessone of Fairview Heights, LLC Physical Therapist Past Accepting new patients
Wellnessone of East Belleville, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063452308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9684 MALLARD DR",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622582754",
            "telephone_number": "618-566-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10607 LINCOLN TRL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081913",
            "telephone_number": "618-310-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KRISTEN",
        "middle_name": "R",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.