Individual provider Active NPI

Kristi Burgess, DPT

  • Physical Therapist
  • Concord, NC
National Provider Identifier
1265169585
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21488 Issued in NC
Practice address
1195 Drake Mill LN SW
Concord, NC 28025-8561
Phone
(704) 251-2602
NPI assigned
Aug 5, 2022
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 P21488 NC Primary

Addresses

Primary practice location

1195 Drake Mill LN SW
Concord, NC 28025-8561

Mailing address

8416 Strathburn CT Apt B
Huntersville, NC 28078-2826
Phone (518) 763-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230207001112 NC Practitioner - Physical Therapist in Private Practice 4587036223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Oct 19, 2022 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 19, 2022 Accepting new patients

Locations

1195 Drake Mill Ln SW
Concord, NC 28025
Phone (704) 251-2602

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1265169585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8416 STRATHBURN CT APT B",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280782826",
            "telephone_number": "518-763-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 DRAKE MILL LN SW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280258561",
            "telephone_number": "704-251-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KRISTI",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.