Kurtis Lackland, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011452 Issued in GA

Practice address

3075 Tower Rd
Suite a
Columbus, GA 31909-2536

Phone

(706) 507-3794

Fax

(706) 507-3681

NPI assigned

Sep 18, 2009

Sex

Male

Sole proprietor

No

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

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Missouri Physical Therapy LLCGroup PAC ID 6901870187, 59 clinicians

Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boone Physician Services, LLC

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1760893259
  Medicare reassignment Care Compare group NPD
• Central Missouri Physical Therapy LLC

  dba Peak Sport and Spine

  • Physical Therapist
  • Columbia, MO
  • NPI 1558436592
  Medicare reassignment Care Compare group NPD
• Atlas Physical Therapy & Sports Medicine

  • Specialist
  • Fulton, MO
  • NPI 1568459378

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1316271679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N HOSPITAL DR",
            "address_2": "SUITE H",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512535",
            "telephone_number": "573-642-8541",
            "fax_number": "573-642-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 TOWER RD",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092536",
            "telephone_number": "706-507-3794",
            "fax_number": "706-507-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKLAND",
        "first_name": "KURTIS",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2009028456",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya C Kyles, LPC
• L.I.T. Wellness Center, LLC
• Laboratory Corporation of America Holdings
• Laboromniavincit LLC (Veritas Spine & Joint)
• Cherington Lackland
• Ke'Andrea Ladson
• Rakeshia Lashae Lafavor
• Angela Lagrand
• Latanya Lagrand
• William Robert Lahouse, M.D.

• Physical Therapist in Columbus, GA
• Providers in Columbus, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.