Individual provider Active NPI

Kristen Taranto Humphries, PT, DPT, ATC, LAT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1558730655
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT30388 Issued in AZ
Practice address
1880 W Orange Grove Rd
Tucson, AZ 85704-1129
Phone
(520) 884-9819
Fax
(520) 884-0175
NPI assigned
Sep 18, 2015
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10971 TN
Physical Therapist 225100000X LPT30388 AZ Primary
Athletic Trainer 2255A2300X AL3752 FL

Addresses

Primary practice location

1880 W Orange Grove Rd
Tucson, AZ 85704-1129

Mailing address

1777 W Saint Marys Rd
Tucson, AZ 85745-2687
Phone (520) 884-9819

Other practice location 1

4635 Greenway Dr
Unit B
Knoxville, TN 37918-2118
Phone (865) 546-0801

Other names 1

  • Miss Kristen Mary Taranto 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10971TNMDPharmacist
LPT30388AZMDPhysical Therapist
AL3752FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC CurrentSince Oct 26, 2020 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Oct 26, 2020 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 3

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1558730655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 W SAINT MARYS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452687",
            "telephone_number": "520-884-9819",
            "fax_number": "520-884-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041129",
            "telephone_number": "520-884-9819",
            "fax_number": "520-884-0175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4635 Greenway Dr",
            "address_2": "Unit B",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379182118",
            "country_code": "US",
            "telephone_number": "865-546-0801",
            "fax_number": "865-546-0086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "KRISTEN",
        "middle_name": "TARANTO",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10971",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT30388",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "TARANTO",
            "middle_name": "MARY",
            "prefix": "MISS",
            "credential": "ATC, LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.