Active NPI
Kimberly Dayon Kinkito
- Physical Therapist
- La Grande, OR
National Provider Identifier
1174790240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5542
- Practice address
- 103 Adams Ave
La Grande, OR 97850-9532 - Phone
- (646) 522-5266
- NPI assigned
- May 8, 2008
- Last updated
- Apr 28, 2009
- 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 | 5542 | OR | Primary |
Addresses
Primary practice location
103 Adams Ave
La Grande, OR 97850-9532
Mailing address
1205 Adams Ave
Apt. # 7
La Grande, OR 97850-2650
Phone (646) 522-5266
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5542 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1174790240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 ADAMS AVE",
"address_2": "APT. # 7",
"city": "LA GRANDE",
"state": "OR",
"postal_code": "978502650",
"telephone_number": "646-522-5266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 ADAMS AVE",
"city": "LA GRANDE",
"state": "OR",
"postal_code": "978509532",
"telephone_number": "646-522-5266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINKITO",
"first_name": "KIMBERLY",
"middle_name": "DAYON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-08",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "5542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Grande, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.