Active NPI
Kyle Lee Atwell, PT, DPT, OMPT, CMTPT
- Physical Therapist
- Annapolis, MD
National Provider Identifier
1144653379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24583
- Practice address
- 406 Duckbill LN
Annapolis, MD 21409-5489 - Phone
- (301) 661-3645
- NPI assigned
- Aug 12, 2013
- Last updated
- Dec 30, 2015
- 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 | 24583 | MD | Primary |
Addresses
Primary practice location
406 Duckbill LN
Annapolis, MD 21409-5489
Mailing address
406 Duckbill LN
Annapolis, MD 21409-5489
Phone (301) 661-3645
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24583 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gofit Physical Therapy, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Annapolis, MD
- NPI 1467947374
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1144653379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 DUCKBILL LN",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214095489",
"telephone_number": "301-661-3645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 DUCKBILL LN",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214095489",
"telephone_number": "301-661-3645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWELL",
"first_name": "KYLE",
"middle_name": "LEE",
"credential": "PT, DPT, OMPT, CMTPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-12",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.