Individual provider Active NPI

Todd M Kersten, P.T.

  • Physical Therapist
  • Davenport, IA
National Provider Identifier
1598715757
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03248 Issued in IA
Practice address
1008 W 35TH St
Davenport, IA 52806-5827
Phone
(563) 324-2263
Fax
(563) 324-0719
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-008258 IL
Physical Therapist 225100000X 03248 IA Primary

Addresses

Primary practice location

1008 W 35TH St
Davenport, IA 52806-5827

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other identifiers 2

IdentifierTypeStateIssuer
03248OtherIAIOWA PT LICENSE NO.
070-008258OtherILILLINOIS PT LICENSE NO

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
03248IAMDPhysical Therapist
070-008258ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ora Orthopedics, PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1598715757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 W 35TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065827",
            "telephone_number": "563-324-2263",
            "fax_number": "563-324-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSTEN",
        "first_name": "TODD",
        "middle_name": "M",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-008258",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA PT LICENSE NO.",
            "identifier": "03248",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PT LICENSE NO",
            "identifier": "070-008258",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.