Individual provider Active NPI

Christine A. Iverson

  • Physical Therapist
  • Ft. Campbell, KY
National Provider Identifier
1215047725
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9296 Issued in CO
Practice address
650 Joel Drive
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223-5349
Phone
(270) 798-8372
Fax
(270) 956-0180
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9296 CO Primary

Addresses

Primary practice location

650 Joel Drive
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223-5349

Mailing address

650 Joel Drive
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223-5349
Phone (270) 798-8372

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

LicenseStateTypeSpecialty
9296COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215047725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "city": "FT. CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8372",
            "fax_number": "270-956-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "city": "FT. CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8372",
            "fax_number": "270-956-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "CHRISTINE",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "9296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.