Active NPI
Vincent Kortbawi
- Physical Therapist
- Moundville, AL
National Provider Identifier
1235693896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH9071
- Practice address
- 40870 Al Highway 69
Moundville, AL 35474-4366 - Phone
- (205) 450-9114
- NPI assigned
- Jan 29, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH9071 | AL | Primary |
Addresses
Primary practice location
40870 Al Highway 69
Moundville, AL 35474-4366
Mailing address
245 Cahaba Valley Pkwy Ste 200
Pelham, AL 35124-2217
Phone (205) 942-6820
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTH9071 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1235693896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 CAHABA VALLEY PKWY STE 200",
"city": "PELHAM",
"state": "AL",
"postal_code": "351242217",
"telephone_number": "205-942-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40870 AL HIGHWAY 69",
"city": "MOUNDVILLE",
"state": "AL",
"postal_code": "354744366",
"telephone_number": "205-450-9114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORTBAWI",
"first_name": "VINCENT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-29",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH9071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moundville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.