Individual provider Active NPI

Kirsten Zambon, PT, DPT, CLT

  • Physical Therapist
  • West Lafayette, IN
National Provider Identifier
1144756453
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05012126A Issued in IN
Practice address
909 Sagamore Pkwy W Ste 917
West Lafayette, IN 47906-1443
Phone
(765) 463-0710
Fax
(765) 463-0711
NPI assigned
May 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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 05012126A IN
Physical Therapist 225100000X 05012126A IN Primary

Addresses

Primary practice location

909 Sagamore Pkwy W Ste 917
West Lafayette, IN 47906-1443

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

1260 N 17th St
Lafayette, IN 47904-2163
Phone (765) 423-6885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825001690 IN Practitioner - Physical Therapist in Private Practice 7214311273 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince May 25, 2022 Accepting new patients
Franciscan Physician Network CurrentSince May 25, 2022 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

1260 N 17th St
Lafayette, IN 47904
Phone (765) 423-6011

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

909 Sagamore Pkwy W
Ste 917
West Lafayette, IN 47906
Phone (765) 463-0710

Organizations & group practices 2

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": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1144756453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SAGAMORE PKWY W STE 917",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061443",
            "telephone_number": "765-463-0710",
            "fax_number": "765-463-0711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 N 17th St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479042163",
            "country_code": "US",
            "telephone_number": "765-423-6885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMBON",
        "first_name": "KIRSTEN",
        "credential": "PT, DPT, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IN",
            "license": "05012126A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012126A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.