Organization Active NPI

Kaizen Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Durham, NC
National Provider Identifier
1083182265
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KAIZEN PHYSICAL THERAPY LLC
Practice address
5102 Durham Chapel Hill Blvd Ste 214
Durham, NC 27707-3394
Phone
(919) 617-6134
NPI assigned
Nov 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Derek Nielsen, DPT
Title
Owner/Physical Therapist
Phone
(801) 663-4092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5102 Durham Chapel Hill Blvd Ste 214
Durham, NC 27707-3394

Mailing address

5102 Durham Chapel Hill Blvd Ste 214
Durham, NC 27707-3394
Phone (919) 617-6134

National Provider Directory

National Provider Directory

Locations

5102 Durham Chapel Hill Blvd
Ste 214
Durham, NC 27707
Phone (919) 617-6134

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1083182265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 DURHAM CHAPEL HILL BLVD STE 214",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073394",
            "telephone_number": "919-617-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 DURHAM CHAPEL HILL BLVD STE 214",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073394",
            "telephone_number": "919-617-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIZEN PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "801-663-4092",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.