NPIMap

Organization Active NPI

Kvptc, LLC

  • Physical Therapist
  • Dunbar, WV
National Provider Identifier
1205933579
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1112 Issued in WV
Legal business name
KVPTC, LLC
Practice address
1313 Dunbar Ave
Dunbar, WV 25064
Phone
(304) 768-3307
Fax
(304) 768-3620
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ferdinand P. Sorongon, PHYSICAL THERAPIST
Title
Administrator
Phone
(304) 768-3307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1112 WV Primary

Addresses

Primary practice location

1313 Dunbar Ave
Dunbar, WV 25064

Mailing address

1313 Dunbar Ave
Dunbar, WV 25064
Phone (304) 768-3307

Other identifiers 2

IdentifierTypeStateIssuer
0206427-000MedicaidWV
0156761000MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205933579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 DUNBAR AVE",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "25064",
            "telephone_number": "304-768-3307",
            "fax_number": "304-768-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 DUNBAR AVE",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "25064",
            "telephone_number": "304-768-3307",
            "fax_number": "304-768-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KVPTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SORONGON",
        "authorized_official_first_name": "FERDINAND",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "304-768-3307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "1112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206427-000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156761000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunbar, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.