Active NPI
Kyle Lassiter
- Physical Therapist
- Loveland, CO
National Provider Identifier
1205167897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10862
- Practice address
- 295 E 29TH St
Suite 10
Loveland, CO 80538-2743 - Phone
- (970) 663-6142
- Fax
- (970) 635-3087
- NPI assigned
- Jan 20, 2010
- Last updated
- Nov 15, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 35469 | CA | |
| Physical Therapist | 225100000X | 10862 | CO | Primary |
Addresses
Primary practice location
295 E 29TH St
Suite 10
Loveland, CO 80538-2743
Mailing address
295 E 29TH St
Suite 10
Loveland, CO 80538-2743
Phone (970) 663-6142
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 |
|---|---|---|---|
| PT 35469 | CA | MD | Physical Therapist |
| 10862 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1205167897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 E 29TH ST",
"address_2": "SUITE 10",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805382743",
"telephone_number": "970-663-6142",
"fax_number": "970-635-3087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 E 29TH ST",
"address_2": "SUITE 10",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805382743",
"telephone_number": "970-663-6142",
"fax_number": "970-635-3087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASSITER",
"first_name": "KYLE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-20",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 35469",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "10862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loveland, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.