Individual provider Active NPI

Kory Kindle, PT

  • Physical Therapist
  • Atascadero, CA
National Provider Identifier
1407443211
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT299678 Issued in CA
Practice address
6907 El Camino Real Ste D
Atascadero, CA 93422-4386
Phone
(805) 466-6719
Fax
(805) 466-5286
NPI assigned
Dec 28, 2020
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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 PT299678 CA Primary

Addresses

Primary practice location

6907 El Camino Real Ste D
Atascadero, CA 93422-4386

Mailing address

1106 Walnut St Ste 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210222002810 CA Practitioner - Physical Therapist in Private Practice 3971918095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Life Physical Therapy Services PCGroup PAC ID 7214207125, 94 clinicians

Practice addresses (Care Compare)

849 Coast Blvd
La Jolla, CA 92037-4223
Phone (858) 456-4231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT299678CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC Physical Therapist CurrentSince Jan 20, 2024 Accepting new patients
Ther RX Physical Therapist Current Accepting new patients

Locations

849 Coast Blvd
La Jolla, CA 92037
Phone (858) 454-2151

12515 Springhurst Dr
San Diego, CA 92128
Phone (858) 771-3694

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1407443211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST STE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 EL CAMINO REAL STE D",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224386",
            "telephone_number": "805-466-6719",
            "fax_number": "805-466-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDLE",
        "first_name": "KORY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT299678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.