Courtney Spongberg, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1105340 Issued in KS

Practice address

550 Pope Ave
Fort Leavenworth, KS 66027-2332

Phone

(913) 684-6650

NPI assigned

Jun 10, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1285083162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 46TH TER APT 302",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121500",
            "telephone_number": "402-410-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPONGBERG",
        "first_name": "COURTNEY",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "KS",
            "license": "1105340",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1105340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Fort Leavenworth, KS
• Providers in Fort Leavenworth, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.