Active NPI
Derek Karl Kautzmann, MPT
- Orthopedic Physical Therapist
- Cincinnati, OH
National Provider Identifier
1194797506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 010701
- Practice address
- 6350 Glenway Ave
Suite 415
Cincinnati, OH 45211-6378 - Phone
- (513) 347-9999
- Fax
- (513) 347-3999
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 010701 | OH | |
| Orthopedic Physical Therapist | 2251X0800X | 010701 | OH | Primary |
Addresses
Primary practice location
6350 Glenway Ave
Suite 415
Cincinnati, OH 45211-6378
Mailing address
6350 Glenway Ave
Suite 415
Cincinnati, OH 45211-6378
Phone (513) 347-9999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010701 | Other | OH | OH PT LICENSE |
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 |
|---|---|---|---|
| 010701 | OH | MD | Orthopedic Physical Therapist |
Interoperability endpoints
- dkautzmann90498@direct.bsmhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388620800000",
"number": "1194797506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6350 GLENWAY AVE",
"address_2": "SUITE 415",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452116378",
"telephone_number": "513-347-9999",
"fax_number": "513-347-3999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6350 GLENWAY AVE",
"address_2": "SUITE 415",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452116378",
"telephone_number": "513-347-9999",
"fax_number": "513-347-3999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUTZMANN",
"first_name": "DEREK",
"middle_name": "KARL",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2014-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "010701",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "OH",
"license": "010701",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH PT LICENSE",
"identifier": "010701",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.