Individual provider Active NPI

Kristen Lepage, DPT

  • Physical Therapist
  • Brewer, ME
National Provider Identifier
1164831822
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4278 Issued in ME
Practice address
797 Wilson St
Brewer, ME 04412-1000
Phone
(207) 924-0077
Fax
(207) 924-0078
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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 PT4278 ME Primary

Addresses

Primary practice location

797 Wilson St
Brewer, ME 04412-1000

Mailing address

797 Wilson St
Brewer, ME 04412-1000
Phone (207) 924-0077

Other identifiers 1

IdentifierTypeStateIssuer
PT4278OtherMEPHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140820002830 ME Practitioner - Physical Therapist in Private Practice 9638397417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Motion Physical Therapy LLCGroup PAC ID 7416926704, 57 clinicians

Practice addresses (Care Compare)

797 Wilson St
Brewer, ME 04412-1000
Phone (207) 992-4042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Motion Physical Therapy, LLC Physical Therapist CurrentSince Oct 17, 2017 Accepting new patients

Locations

797 Wilson St
Brewer, ME 04412
Phone (207) 992-4042

1008 W Main St
Dover Foxcroft, ME 04426
Phone (207) 564-8710

94 Main St
Gorham, ME 04038
Phone (207) 839-5225

4 Main St
Unit T2
Newport, ME 04953
Phone (207) 924-0077

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": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1164831822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 WILSON ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121000",
            "telephone_number": "207-924-0077",
            "fax_number": "207-924-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 WILSON ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121000",
            "telephone_number": "207-924-0077",
            "fax_number": "207-924-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPAGE",
        "first_name": "KRISTEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT4278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT4278",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.