Individual provider Active NPI

Kamylle Michelle Coleman, PT, DPT

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1508233628
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0015610 Issued in CO
Practice address
5446 N Academy Blvd Ste 105
Colorado Springs, CO 80918-3668
Phone
(719) 598-5555
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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 PTL.0015610 CO Primary

Addresses

Primary practice location

5446 N Academy Blvd Ste 105
Colorado Springs, CO 80918-3668

Mailing address

5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669
Phone (719) 598-5555

Other names 1

  • Kamylle Michelle Palomino Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0015610COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellcare Inc. Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Nurture Home Health Care Inc PastSince Jun 1, 2020 Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients
Barr Physical Therapy, P.C. Physical Therapist PastSince Dec 27, 2022 Accepting new patients

Locations

5446 N Academy Blvd
Ste 204
Colorado Springs, CO 80918
Phone (719) 400-7612

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1508233628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183668",
            "telephone_number": "719-598-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "KAMYLLE",
        "middle_name": "MICHELLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0015610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAMYLLE",
            "last_name": "PALOMINO",
            "middle_name": "MICHELLE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.