Kristen Michelle Goldberg, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004469 Issued in GA

Practice address

544 Yellowstone Ave
Cody, WY 82414-9300

Phone

(307) 587-9789

Fax

(307) 587-9787

NPI assigned

Feb 27, 2013

Last updated

Aug 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristen Michelle Thompson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canyon Hand Therapy, P.C.

  dba Canyon Therapy

  • Physical Therapy Clinic/Center
  • Cody, WY
  • NPI 1639476443
  NPD
• Independent Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Covington, GA
  • NPI 1962743674
  NPD (past)

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1235479361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149300",
            "telephone_number": "307-587-9789",
            "fax_number": "307-587-9787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11186 Highway 142 N",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142547",
            "country_code": "US",
            "telephone_number": "678-712-3692",
            "fax_number": "678-712-3693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT004469",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "THOMPSON",
            "middle_name": "MICHELLE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua George, D.D.S.
• Landon Neves George, NP, RN
• Theresa George
• Alisha Getzfreid
• Maggi Jo Giraud, LMHP, LADC, LPC
• Holly Goodman
• Colt Gordon, LCSW 110973
• Cheryl Gould
• Travis S Graham, MD
• Shelly Marie Green, CRNA

• Physical Therapist in Cody, WY
• Providers in Cody, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.