Individual provider Active NPI

Derek Karl Kautzmann, MPT

  • Orthopedic Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1194797506
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
010701 Issued in OH
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

Updated by the provider on Jan 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
010701OtherOHOH 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

LicenseStateTypeSpecialty
010701OHMDOrthopedic Physical Therapist

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.