Individual provider Active NPI

Kelly Hornberger

  • Physical Therapist
  • Washington, IL
National Provider Identifier
1164904504
Registry record updated Sep 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.007133 Issued in IL
Practice address
1201 Newcastle Rd.
Washington, IL 61571
Phone
(309) 444-3161
NPI assigned
Sep 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2018

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 070.007133 IL Primary

Addresses

Primary practice location

1201 Newcastle Rd.
Washington, IL 61571

Mailing address

617 W. Jefferson St.
Washington, IL 61571

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
070.007133ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535760000000",
    "number": "1164904504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 W. JEFFERSON ST.",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "61571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NEWCASTLE RD.",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "61571",
            "telephone_number": "309-444-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNBERGER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-01",
        "last_updated": "2018-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.007133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2018; 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.