Kyle Pulford

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23926 Issued in MA

Practice address

4613 Duke St Ste B
Alexandria, VA 22304-2559

Phone

(703) 751-1052

Fax

(703) 751-1053

NPI assigned

Sep 26, 2018

Last updated

Mar 15, 2021By the provider in NPPES

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 DC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433

  DC

  Medicare reassignment Care Compare group NPD
• Professional Sportscare & Rehab, LLC

  dba Pivot Physical Therapy of Metro DC

  • Clinic/Center
  • Winchester, VA
  • NPI 1033142294

  DC, Physical Therapist

  Medicare reassignment NPD
• Ivyrehab Sept, LLC

  • Physical Medicine & Rehabilitation Physician
  • Verona, VA
  • NPI 1235955709

  Physical Therapist

  NPD

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1508341587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 DUKE ST STE B",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042559",
            "telephone_number": "703-751-1052",
            "fax_number": "703-751-1053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Adams St",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "MA",
            "postal_code": "021864914",
            "country_code": "US",
            "telephone_number": "619-696-8141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULFORD",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214202",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chettia Provost, DC
• Katherine Prudden, LCSW
• Emily Prusator, LCSW
• Kathleen H. Prussian, FNP-C
• George Spencer Pugh, DDS
• Parvathi N Pullanchodan
• Jocelyn Puller, LCSW
• Pulmonary Associates LTD
• Pulse Healthcare Company
• Stacey Punnett, RDN, LD

• Physical Therapist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.