Active NPI
Kim Oliver Visperas Romero, DPT
- Physical Therapist
- Hurricane, WV
National Provider Identifier
1073960191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT003616
- Practice address
- 3948 Teays Valley Rd Ste 1320
Hurricane, WV 25526-8728 - Phone
- (304) 757-1764
- NPI assigned
- May 18, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003616 | WV | |
| Physical Therapist | 225100000X | PT003616 | WV | Primary |
Addresses
Primary practice location
3948 Teays Valley Rd Ste 1320
Hurricane, WV 25526-8728
Mailing address
400 Association Dr Ste 102
Charleston, WV 25311-1298
Phone (304) 388-0015
Other practice location 1
3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432
Other practice location 2
600 Tracy Way
Charleston, WV 25311-1262
Phone (304) 388-4900
Other practice location 3
501 Morris St
Charleston, WV 25301-1326
Phone (304) 647-6006
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003616 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1073960191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 ASSOCIATION DR STE 102",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111298",
"telephone_number": "304-388-0015",
"fax_number": "304-388-0019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3948 TEAYS VALLEY RD STE 1320",
"city": "HURRICANE",
"state": "WV",
"postal_code": "255268728",
"telephone_number": "304-757-1764"
}
],
"practiceLocations": [
{
"address_1": "3200 MacCorkle Ave SE",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253041227",
"country_code": "US",
"telephone_number": "304-388-5432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 Tracy Way",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253111262",
"country_code": "US",
"telephone_number": "304-388-4900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "501 Morris St",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253011326",
"country_code": "US",
"telephone_number": "304-647-6006",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROMERO",
"first_name": "KIM OLIVER",
"middle_name": "VISPERAS",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-18",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "003616",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "PT003616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurricane, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.