Kristin Audra Maynes, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

43116 Issued in CA

Practice address

227 N El Camino Real
Suite 103
Encinitas, CA 92024-2807

Phone

(760) 230-2316

NPI assigned

Sep 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Function for Life Physical Therapy, Inc.

  dba Longevity Physical Therapy

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1568767309
  NPD (past)
• Function for Life PT Inc

  dba Longevity Physical Therapy

  • Preferred Provider Organization
  • Encinitas, CA
  • NPI 1811310170
  NPD (past)

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1235509860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 TAMARACK AVE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920083419",
            "telephone_number": "760-521-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N EL CAMINO REAL",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242807",
            "telephone_number": "760-230-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNES",
        "first_name": "KRISTIN",
        "middle_name": "AUDRA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marie Maxwell, DPT
• Alexis May
• Lisa Marie Maya-Peinl, LVN
• Jennifer Elizabeth Mayer, MS, RD
• Elizabeth Lindsay Mayi, CRNA
• Megen D McBride, ND
• Meagan McBryde, M.D., M.P.H.
• Michelle McCadden, SLP
• Ashley McCafferty, OD
• Gabriella McCann, DPT

• Physical Therapist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.