Kimberly Ann Harris, D.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

030783-1 Issued in NY

Practice address

8 Douglaston Rd
Sound Beach, NY 11789-1612

Phone

(631) 849-2633

NPI assigned

Dec 17, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

State University of New York at Stony Brook, School of Medicine, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Kah Premium Physical Therapy P.C.Group PAC ID 2961674791, 3 clinicians

Practice addresses (Care Compare)

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.

• Kah Premium Physical Therapy P.C.

  • Physical Therapist
  • Stony Brook, NY
  • NPI 1922396373
  Medicare reassignment Care Compare group NPD Authorized official
• Three Village Physical Therapy PLLC

  dba Three Village Physical Therapy & Fitness

  • Physical Therapist
  • Stony Brook, NY
  • NPI 1831260504
  NPD (past)

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1598901746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DOUGLASTON RD",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117891612",
            "telephone_number": "631-849-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DOUGLASTON RD",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117891612",
            "telephone_number": "631-849-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "D.P.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laran Genc, LPN
• Michelle Ging
• Joni-Gayle Glass, RN
• Kathryn Green, OT R/L
• Margaret Dolores Griskauskas, R.N.
• Nicole Heaton
• Anni Kristine Hegeland
• Hollie M Hendrickson
• Danielle Hyne, MS
• Holly Jacobsen, RN

• Physical Therapist in Sound Beach, NY
• Providers in Sound Beach, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.