Kaylynne B. Ezzell, M.P.T.
Individual provider Active NPI Physical Therapist · Gunnison, CO
NPI 1154504165 · NPPES record last updated Oct 18, 2012
Key facts
- NPI
- 1154504165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 9780 (CO)
- Practice address
- 718 N Main St
Unit # 18
Gunnison, CO 81230-2412 - Phone
- (970) 641-3298
- Fax
- (970) 641-7369
- NPI assigned
- Dec 12, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Heights Physical Therapy LLC
Practice addresses (Care Compare)
700 N Main St
Unit B
Gunnison, CO 81230-2423
Phone (970) 641-3298
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121217000421 | CO | Practitioner - Physical Therapist in Private Practice | 2961650015 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9780 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heights Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Heights Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
718 N Main St
Unit 18
Gunnison, CO 81230
Phone (970) 641-3298
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9780 | CO | Yes |
Addresses
Primary practice location
718 N Main St
Unit # 18
Gunnison, CO 81230-2412
Mailing address
718 N Main St
Unit # 18
Gunnison, CO 81230-2412
Phone (970) 641-3298
Other providers in Gunnison, CO
- Elk Mountain Therapy Associates, LLC
- Samuel Elzay
- Emily Parsons LLC
- Alonso Escalante
- Matthew Robert Estrada
- Trent M Ezzell
- Family Vision Center, LLC
- Carla Fanciullo
- Lara Fellows
- Emily Ferrell
All providers in Gunnison, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.