Individual provider Active NPI

Kassie Kime, DPT

  • Physical Therapist
  • Fairmont, WV
National Provider Identifier
1275123655
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003314 Issued in WV
Practice address
412 Fairmont Ave Ste 2
Fairmont, WV 26554-2792
Phone
(304) 534-9344
NPI assigned
Jan 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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 003314 WV Primary

Addresses

Primary practice location

412 Fairmont Ave Ste 2
Fairmont, WV 26554-2792

Mailing address

1022 Riverview Dr
Fairmont, WV 26554-8308
Phone (304) 677-5477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311000849 WV Practitioner - Physical Therapist in Private Practice 9436595618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
West Virginia University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Stoney Hill Rd
Fairmont, WV 26554-1589
Phone (304) 285-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003314WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Nov 28, 2023 Accepting new patients
West Virginia University Medical Corporation CurrentSince Nov 28, 2023 Accepting new patients

Locations

100 Stoney Hill Rd
Fairmont, WV 26554
Phone (304) 285-5400

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

6040 University Town Centre Dr
Morgantown, WV 26501

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1275123655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 RIVERVIEW DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548308",
            "telephone_number": "304-677-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 FAIRMONT AVE STE 2",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542792",
            "telephone_number": "304-534-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIME",
        "first_name": "KASSIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "003314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.