Individual provider Active NPI

Douglas Kemp, PT

  • Physical Therapist
  • Wyomissing, PA
National Provider Identifier
1154388593
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006957L Issued in PA
Practice address
3103 Paper Mill Rd
Wyomissing, PA 19610
Phone
(610) 376-2100
Fax
(610) 750-5806
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT006957L PA Primary

Addresses

Primary practice location

3103 Paper Mill Rd
Wyomissing, PA 19610

Mailing address

3103 Paper Mill Rd
Wyomissing, PA 19610
Phone (610) 376-2100

Other identifiers 3

IdentifierTypeStateIssuer
P00065551OtherPARAILROAD MEDICARE
50029021OtherPACAPITAL BLUE CROSS
689967OtherPAHIGHMARK BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000712 PA Practitioner - Physical Therapist in Private Practice 0547437303 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WRC Sports and Fitness Limited PartnershipGroup PAC ID 2062795727, 2 clinicians

Practice addresses (Care Compare)

3103 Papermill Rd
Wyomissing, PA 19610-3337
Phone (610) 376-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Orthopaedic Specialists LLC CurrentSince Mar 1, 2013 Accepting new patients
Keystone Orthopaedic Specialists LLC Physical Therapist CurrentSince Mar 1, 2013 Accepting new patients
WRC Sports and Fitness Limited Partnership Physical Therapist CurrentSince Mar 14, 2017 Accepting new patients
West Schuylkill Physical Therapy Services, P.C. Physical Therapist PastSince Jan 26, 2017 Accepting new patients
Pottsville Area Physical Therapy Services P.C. Physical Therapist Past Accepting new patients

Locations

11 Fairlane Rd
Reading, PA 19606
Phone (610) 378-8810

301 S 7th Ave
Ste 3020
West Reading, PA 19611
Phone (484) 628-4656

3103 Papermill Rd
Wyomissing, PA 19610
Phone (610) 376-2100

2758 Century Blvd
Ste 2
Wyomissing, PA 19610
Phone (610) 376-5646

1270 Broadcasting Rd
Wyomissing, PA 19610
Phone (610) 372-1140

Organizations & group practices 6

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1154388593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 PAPER MILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "19610",
            "telephone_number": "610-376-2100",
            "fax_number": "610-750-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 PAPER MILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "19610",
            "telephone_number": "610-376-2100",
            "fax_number": "610-750-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "DOUGLAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT006957L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00065551",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50029021",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "689967",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.