Individual provider Active NPI

Rick Kristoffersen, PT

  • Orthopedic Physical Therapist
  • Olathe, KS
National Provider Identifier
1124527072
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
11-00986 Issued in KS
Practice address
1061 E 151St St
Olathe, KS 66062-3417
Phone
(913) 829-3133
Fax
(913) 829-6011
NPI assigned
Feb 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-00986 KS
Orthopedic Physical Therapist 2251X0800X 11-00986 KS Primary

Addresses

Primary practice location

1061 E 151St St
Olathe, KS 66062-3417

Mailing address

1061 E 151St St
Olathe, KS 66062-3417
Phone (913) 829-3133

Other practice location 1

11330 W 135th St
Overland Park, KS 66221-8100
Phone (913) 239-9539

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
11-00986KSMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1124527072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 E 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660623417",
            "telephone_number": "913-829-3133",
            "fax_number": "913-829-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 E 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660623417",
            "telephone_number": "913-829-3133",
            "fax_number": "913-829-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11330 W 135th St",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662218100",
            "country_code": "US",
            "telephone_number": "913-239-9539",
            "fax_number": "913-239-9893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISTOFFERSEN",
        "first_name": "RICK",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-06",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-00986",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KS",
            "license": "11-00986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.