Individual provider Active NPI

Taylor Kitkowski, PT, DPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1073149613
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31131 Issued in AZ
Practice address
9980 W Glendale Ave
Glendale, AZ 85307-3005
Phone
(623) 242-6908
NPI assigned
Mar 16, 2020
Last updated
Mar 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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 31131 AZ Primary

Addresses

Primary practice location

9980 W Glendale Ave
Glendale, AZ 85307-3005

Mailing address

9980 W Glendale Ave
Glendale, AZ 85307-3005
Phone (623) 242-6908

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tkitkowski@AZOPT.net

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
31131AZMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: tkitkowski@azopt.net

NPI Registry JSON

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1073149613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853073005",
            "telephone_number": "623-242-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853073005",
            "telephone_number": "623-242-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITKOWSKI",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "31131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkitkowski@AZOPT.net",
            "affiliation": "N",
            "address_1": "9980 W Glendale Ave",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853073005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.