Kristin Marie Somerville, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2824 Rogers Rd Ste 102
Wake Forest, NC 27587-3896

Phone

(919) 229-8363

Fax

(919) 229-8356

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Somerville PT LLC

  • Clinic/Center
  • Charlotte, NC
  • NPI 1710780291
  NPD Authorized official
• Breakthrough Physical Therapy

  • Physical Therapist
  • Morehead City, NC
  • NPI 1083937692
  NPD (past)

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1144775784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 GENTILLY BLVD",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208522",
            "telephone_number": "678-403-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ROGERS RD STE 102",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873896",
            "telephone_number": "919-229-8363",
            "fax_number": "919-229-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012526",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamira Smith, MS
• Virginia Phillippe Smith, MA
• Sol Medical Group PLLC
• Carolyn Kay Solak, PA-C
• Sole Dimensions LLC
• Laura Sotillo, LCSW
• Southern Assisted Living, LLC.
• Southern Eye Care, O.D., PLLC
• Shelley Marie Sparling, PT, DPT
• Katherine Spathelf, PT

• Physical Therapist in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.