Individual provider Active NPI

Emily Kristi Altimont, DPT

  • Physical Therapist
  • Bentonville, AR
National Provider Identifier
1154944874
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5266 Issued in AR
Practice address
103 SE 22ND St
Bentonville, AR 72712-7188
Phone
(479) 254-4044
NPI assigned
May 28, 2020
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PTL.0016956 CO
Physical Therapist 225100000X 5266 AR Primary

Addresses

Primary practice location

103 SE 22ND St
Bentonville, AR 72712-7188

Mailing address

2474 E Joyce Blvd Ste 2
Fayetteville, AR 72703-4932
Phone (479) 521-8326

Other practice location 1

2474 E Joyce Blvd Ste 2
Fayetteville, AR 72703-4932
Phone (795) 218-3264

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5266ARMDPhysical Therapist
PTL.0016956COMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy Services, Inc. Pediatrics PastSince May 7, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1154944874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034932",
            "telephone_number": "479-521-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SE 22ND ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127188",
            "telephone_number": "479-254-4044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2474 E Joyce Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727034932",
            "country_code": "US",
            "telephone_number": "795-218-3264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTIMONT",
        "first_name": "EMILY",
        "middle_name": "KRISTI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CO",
            "license": "PTL.0016956",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.