Active NPI
Kimberly Michele McKinstry, PT
- Physical Therapist
- Diamond Springs, CA
National Provider Identifier
1164623187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT14008
- Practice address
- 4250 Fowler LN Ste 101
Diamond Springs, CA 95619-9782 - Phone
- (530) 306-1497
- Fax
- (530) 344-7589
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | PT14008 | CA | Primary |
Addresses
Primary practice location
4250 Fowler LN Ste 101
Diamond Springs, CA 95619-9782
Mailing address
4224 Fowler LN Ste 102
Diamond Springs, CA 95619-9775
Phone (530) 306-1497
Other practice location 1
2021 Smith Flat Rd
Placerville, CA 95667-5038
Phone (530) 306-1497
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings, LLC | Physical Therapist | Current | Accepting new patients |
Locations
6070 Avenida Encinas
Ste 100
Carlsbad, CA 92011
Phone (760) 444-0102
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1164623187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4224 FOWLER LN STE 102",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "956199775",
"telephone_number": "530-306-1497",
"fax_number": "530-344-7589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4250 FOWLER LN STE 101",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "956199782",
"telephone_number": "530-306-1497",
"fax_number": "530-344-7589"
}
],
"practiceLocations": [
{
"address_1": "2021 Smith Flat Rd",
"address_purpose": "LOCATION",
"city": "Placerville",
"state": "CA",
"postal_code": "956675038",
"country_code": "US",
"telephone_number": "530-306-1497",
"fax_number": "530-295-0607",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKINSTRY",
"first_name": "KIMBERLY",
"middle_name": "MICHELE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT14008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Diamond Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.