Individual provider Active NPI

Kaleigh Kristine Burnworth, DPT

  • Physical Therapist
  • Corona, CA
National Provider Identifier
1568849149
Registry record updated Jan 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42364 Issued in CA
Practice address
800 S Main St
Corona, CA 92882-3420
Phone
(951) 737-4343
NPI assigned
May 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2020

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 42364 CA Primary

Addresses

Primary practice location

800 S Main St
Corona, CA 92882-3420

Mailing address

12083 Geode St
Jurupa Valley, CA 91752-4465

Other identifiers 1

IdentifierTypeStateIssuer
PT42364OtherCAPT LICENSE

Other names 1

  • Kaleigh Kristine Lindblom 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

NPI Registry JSON

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578787200000",
    "number": "1568849149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12083 GEODE ST",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917524465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823420",
            "telephone_number": "951-737-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNWORTH",
        "first_name": "KALEIGH",
        "middle_name": "KRISTINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-02",
        "last_updated": "2020-01-12",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT42364",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALEIGH",
            "last_name": "LINDBLOM",
            "middle_name": "KRISTINE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2020; 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.