Active NPI
Kristen Omohundro, D.P.T.
- Physical Therapist
- Reno, NV
National Provider Identifier
1164032348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4280
- Practice address
- 5255 Longley LN Ste 140
Reno, NV 89511-5201 - Phone
- (775) 225-6622
- Fax
- (256) 522-5157
- NPI assigned
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4280 | NV | Primary |
Addresses
Primary practice location
5255 Longley LN Ste 140
Reno, NV 89511-5201
Mailing address
5255 Longley LN Ste 140
Reno, NV 89511-5201
Phone (775) 225-6622
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4280 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1164032348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5255 LONGLEY LN STE 140",
"city": "RENO",
"state": "NV",
"postal_code": "895115201",
"telephone_number": "775-225-6622",
"fax_number": "256-522-5157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5255 LONGLEY LN STE 140",
"city": "RENO",
"state": "NV",
"postal_code": "895115201",
"telephone_number": "775-225-6622",
"fax_number": "256-522-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMOHUNDRO",
"first_name": "KRISTEN",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-03",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "4280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.