Kyle Jordan Blair, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

002973 Issued in WV

Practice address

23 Fitness LN
Berkeley Springs, WV 25411-7080

Phone

(304) 258-1300

Fax

(304) 258-1400

NPI assigned

Sep 9, 2011

Last updated

Sep 9, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1295016814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FITNESS LN",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254117080",
            "telephone_number": "304-258-1300",
            "fax_number": "304-258-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 FITNESS LN",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254117080",
            "telephone_number": "304-258-1300",
            "fax_number": "304-258-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "KYLE",
        "middle_name": "JORDAN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berkeley Springs Dentistry
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• Berkeley Springs Surgical Corp., P.C.
• Jai E Birch
• Lorraine Bird
• Kimberly Irene Blanton
• Kelly Bohrer
• Kenneth Bolden
• Richard Zel Bolden
• Honey Melanie Jeanne Bonjour, MS, CFLE

• Physical Therapist in Berkeley Springs, WV
• Providers in Berkeley Springs, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.