Individual provider Active NPI

Kristen Ann Ayers Ortale

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1245759786
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16930 Issued in NC
Practice address
2108 South Blvd Ste 202
Charlotte, NC 28203-5098
Phone
(704) 287-3930
NPI assigned
Sep 15, 2017
Last updated
Sep 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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 16930 NC Primary

Addresses

Primary practice location

2108 South Blvd Ste 202
Charlotte, NC 28203-5098

Mailing address

1100 Wimbledon Rd
Charlotte, NC 28209-2561

Other names 1

  • Kristen Ann Ayers Former name

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
16930NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1245759786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WIMBLEDON RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 SOUTH BLVD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035098",
            "telephone_number": "704-287-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTALE",
        "first_name": "KRISTEN",
        "middle_name": "ANN AYERS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "16930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "AYERS",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; 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.