Ethan Kitchell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0015116 Issued in CO

Practice address

2115 Grand Ave
Grand Junction, CO 81501-8007

Phone

(970) 254-4872

NPI assigned

Aug 15, 2017

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Mesa County Valley School District #51

  • Local Education Agency (LEA)
  • Grand Junction, CO
  • NPI 1851475628
  NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1578089116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 GRAND AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018007",
            "telephone_number": "970-254-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 GRAND AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018007",
            "telephone_number": "970-254-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHELL",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0015116",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "PTL.0015116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine L. Kisselburgh, M.A.E.
• Crystal Reanee Kisselburgh, MA, LAC, LPCC
• Julie Kissner
• Pamela Jean Kistenmacher
• Kit W Haddow, DDS
• Melissa Kitchell, CCC-SLP
• Mary Jayne Kitchens, RN
• Leslie Spring Kittel, MA, MM, LPCC, NCC
• Karla Lynne Kitzman, MFTC
• Chris K Kjellerson, LPN

• Physical Therapist in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.