Individual provider Active NPI

Kristin Deann Kline, PT, DPT

  • Physical Therapist
  • Fayetteville, NC
National Provider Identifier
1275310708
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
MP990013 Issued in NC
Practice address
501 Executive PL
Fayetteville, NC 28305-5390
Phone
(910) 423-5550
Fax
(910) 423-5552
NPI assigned
Sep 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 304727 CA
Physical Therapist 225100000X MP990013 NC Primary

Addresses

Primary practice location

501 Executive PL
Fayetteville, NC 28305-5390

Mailing address

501 Executive PL
Fayetteville, NC 28305-5390
Phone (910) 423-5550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506000452 NC Practitioner - Physical Therapist in Private Practice 7810337094 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304727CAMDPhysical Therapist
MP990013NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy Solutions LLC Physical Therapist CurrentSince Apr 8, 2024 Accepting new patients
Van Dusen Physical Therapy Inc Physical Therapist PastSince Sep 1, 2023 Accepting new patients

Locations

501 Executive Pl
Fayetteville, NC 28305
Phone (910) 423-5550

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": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1275310708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 EXECUTIVE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055390",
            "telephone_number": "910-423-5550",
            "fax_number": "910-423-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 EXECUTIVE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055390",
            "telephone_number": "910-423-5550",
            "fax_number": "910-423-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "KRISTIN",
        "middle_name": "DEANN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304727",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "MP990013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.