Individual provider Active NPI

Kerwin M Yenter, PT

  • Sports Physical Therapist
  • Orland Park, IL
National Provider Identifier
1114126794
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
070013489 Issued in IL
Practice address
16450 104TH Ave
Orland Park, IL 60467-5441
Phone
(708) 364-8441
Fax
(708) 364-8443
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X
Sports Physical Therapist 2251S0007X 070013489 IL Primary

Addresses

Primary practice location

16450 104TH Ave
Orland Park, IL 60467-5441

Mailing address

4941 Rose Ave
Downers Grove, IL 60515-3202
Phone (312) 909-9525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041029000473 IL Practitioner - Physical Therapist in Private Practice 8426010752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5021 Chase Ave
Downers Grove, IL 60515-4014
Phone (630) 929-5377

Merit-based Incentive Payment System (MIPS)

Final score
90.43 of 100Reported as group
Quality
92.42
Improvement activities
40
Cost
72.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Physical Therapy Center LLC Sports CurrentSince Oct 14, 2024 Accepting new patients

Locations

5021 Chase Ave
Downers Grove, IL 60515
Phone (630) 929-5377

Organizations & group practices 1

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1114126794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 ROSE AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153202",
            "telephone_number": "312-909-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16450 104TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675441",
            "telephone_number": "708-364-8441",
            "fax_number": "708-364-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENTER",
        "first_name": "KERWIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "IL",
            "license": "070013489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.