Kevin L. Outwater Sr., PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-04320 Issued in OH

Practice address

2660 W Market St
Ste 300
Fairlawn, OH 44333-4202

Phone

(330) 869-2635

Fax

(330) 869-8315

NPI assigned

Jun 14, 2005

Last updated

Oct 24, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PT Center LLCGroup PAC ID 9739575986, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• PT Center LLC

  • Physical Therapist
  • Fairlawn, OH
  • NPI 1467115030
  Medicare reassignment Care Compare group NPD Authorized official
• The PT Center for Sports Medicine

  • Athletic Trainer
  • Fairlawn, OH
  • NPI 1578815973
  NPD (past)
• The PT Center for Sports Medicine

  • Athletic Trainer
  • Fairlawn, OH
  • NPI 1972856524
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1114922556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST",
            "address_2": "STE 300",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334206",
            "telephone_number": "330-869-2635",
            "fax_number": "330-869-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST",
            "address_2": "STE 300",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334202",
            "telephone_number": "330-869-2635",
            "fax_number": "330-869-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTWATER",
        "first_name": "KEVIN",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-04320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ohioguidestone
• Olympic Urogynecology, LLC
• Mary Margaret Ondack, LISW
• Jason S. Opritza
• Gina Marie Oriti, MSSA, LISW
• Steven M Oyakawa, M.D.
• Careya Pace
• Gvann Pace
• Jillian Pace
• Palladium Care Inc. (Homewatch CareGivers)

• Physical Therapist in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.