Active NPI
Kyle Owen Fleischmann, PT
- Physical Therapist
- Bend, OR
National Provider Identifier
1144202094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4385
- Practice address
- 1465 SW Knoll Ave
Suite 207
Bend, OR 97702-3261 - Phone
- (541) 550-7291
- Fax
- (541) 550-7356
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4385 | OR | Primary |
Addresses
Primary practice location
1465 SW Knoll Ave
Suite 207
Bend, OR 97702-3261
Mailing address
PO Box 6173
Bend, OR 97708-6173
Phone (541) 550-7291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181407 | Medicaid | OR |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4385 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144202094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6173",
"city": "BEND",
"state": "OR",
"postal_code": "977086173",
"telephone_number": "541-550-7291",
"fax_number": "541-550-7356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 SW KNOLL AVE",
"address_2": "SUITE 207",
"city": "BEND",
"state": "OR",
"postal_code": "977023261",
"telephone_number": "541-550-7291",
"fax_number": "541-550-7356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEISCHMANN",
"first_name": "KYLE",
"middle_name": "OWEN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "4385",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181407",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.