Active NPI
Kyle Hayes
- Physical Therapy Assistant
- San Diego, CA
National Provider Identifier
1518416007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3667
- Practice address
- 1201 34TH Street
San Diego, CA 92102 - Phone
- (619) 232-1058
- NPI assigned
- Sep 26, 2016
- Last updated
- Jun 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3667 | SC | Primary |
Addresses
Primary practice location
1201 34TH Street
San Diego, CA 92102
Mailing address
111 Wellmore Dr.
Tega Cay, SC 29708
Phone (803) 835-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518416007 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3667 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1518416007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 WELLMORE DR.",
"city": "TEGA CAY",
"state": "SC",
"postal_code": "29708",
"telephone_number": "803-835-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 34TH STREET",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92102",
"telephone_number": "619-232-1058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-26",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "3667",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1518416007",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.