Individual provider Active NPI

Kylie Hall Robertson, DPT

  • Physical Therapist
  • Great Falls, MT
National Provider Identifier
1386922730
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2240 Issued in MT
Practice address
2511 6TH Ave S
Great Falls, MT 59405-3013
Phone
(406) 788-8125
Fax
(406) 761-2688
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2240 MT Primary

Addresses

Primary practice location

2511 6TH Ave S
Great Falls, MT 59405-3013

Mailing address

2511 6TH Ave S
Great Falls, MT 59405-3013
Phone (406) 788-8125

Other names 1

  • Kylie Hall Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120802000548 MT Practitioner - Physical Therapist in Private Practice 2365698644 Practice locations: Great Falls, MT

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2511 6TH Ave S
Great Falls, MT 59405-3013
Phone (406) 788-8125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2240MTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1386922730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 6TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594053013",
            "telephone_number": "406-788-8125",
            "fax_number": "406-761-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 6TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594053013",
            "telephone_number": "406-788-8125",
            "fax_number": "406-761-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KYLIE",
        "middle_name": "HALL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "2240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "ANDERSON",
            "middle_name": "HALL",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.