Active NPI
Kimberly F Aul, MSPT
- Physical Therapist
- Santa Rosa, CA
National Provider Identifier
1407802614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT36898
- Practice address
- 3975 Old Redwood Hwy
Mob 5, Suite 154
Santa Rosa, CA 95403-1719 - Phone
- (707) 556-5858
- Fax
- (707) 546-1897
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5073 | TN | |
| Physical Therapist | 225100000X | PT36898 | CA | Primary |
Addresses
Primary practice location
3975 Old Redwood Hwy
Mob 5, Suite 154
Santa Rosa, CA 95403-1719
Mailing address
3975 Old Redwood Hwy
Mob 5, Suite 154
Santa Rosa, CA 95403-1719
Phone (707) 556-5858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT36898 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT36898 | CA | MD | Physical Therapist |
| 5073 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nashville Sports Medicine and Orthopaedic Center PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Nashville, TN
- NPI 1699969097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1407802614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3975 OLD REDWOOD HWY",
"address_2": "MOB 5, SUITE 154",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031719",
"telephone_number": "707-556-5858",
"fax_number": "707-546-1897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3975 OLD REDWOOD HWY",
"address_2": "MOB 5, SUITE 154",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031719",
"telephone_number": "707-556-5858",
"fax_number": "707-546-1897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUL",
"first_name": "KIMBERLY",
"middle_name": "F",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "5073",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT36898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT36898",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.