Kevin A DO, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61529887 Issued in WA

Practice address

3901 Capital Mall Dr SW Ste D
Olympia, WA 98502-8654

Phone

(360) 709-6221

Fax

(360) 359-4727

NPI assigned

Nov 10, 2022

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 OR

Enrollment records 1

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 and National Provider Directory roles.

• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD
• Physical Therapy Specialists

  • Orthopedic Physical Therapist
  • Happy Valley, OR
  • NPI 1619665015
  NPD

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1346958113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 CAPITAL MALL DR SW STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-709-6221",
            "fax_number": "360-359-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CAPITAL MALL DR SW STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-709-6221",
            "fax_number": "360-359-4727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 SE 91st Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970863756",
            "country_code": "US",
            "telephone_number": "503-775-4600",
            "fax_number": "503-775-2520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "KEVIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-10",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64744",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61529887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica M Divens, LMT
• Diverse Behavioral Health Clinic LLC
• William Dix, PHARM.D
• Ashley S.R. Dixon, LMP
• Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC
• Chantal E Dobbins
• Kassandra Doble
• Diana Docher
• Klariza Dodson Rodriguez
• Amy Doering

• Physical Therapist in Olympia, WA
• Providers in Olympia, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.