Kim B Anderson, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

05283 Issued in LA

Practice address

1717 E Prien Lake Rd
Suite 1
Lake Charles, LA 70601-0400

Phone

(337) 478-5880

Fax

(337) 478-5879

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Omni Therapy

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1093872491
  NPD (past)
• Partners in Physical Therapy

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1336232925
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1295843712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 TARA AVE",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70611",
            "telephone_number": "337-885-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E PRIEN LAKE RD",
            "address_2": "SUITE 1",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706010400",
            "telephone_number": "337-478-5880",
            "fax_number": "337-478-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KIM",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "05283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Anderson, M.D.
• Andre Anderson II, BS
• Cheryl Anderson, LMT
• James M. Anderson, M.D.
• Kathryn Claire Anderson
• Mark Shane Anderson, RAC, CCDP, CCGC
• Robert Michael Anderson, M.D.
• Terrance Anderson
• Andersons Transportation LLC
• Derek Andrepont

• All providers in Lake Charles, LA
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.