Active NPI
Jason Kyle Colberg, DPT
- Physical Therapist
- Fall River, MA
National Provider Identifier
1619044989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT01932
- Practice address
- 1822 N Main St
Fall River, MA 02720 - Phone
- (508) 678-1425
- Fax
- (508) 678-1496
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT01932 | RI | Primary |
Addresses
Primary practice location
1822 N Main St
Fall River, MA 02720
Mailing address
125 Church Pond Dr
Tiverton, RI 02878-4449
Phone (401) 624-3503
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT01932 | Other | RI | RI LIC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT01932 | RI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1619044989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 CHURCH POND DR",
"city": "TIVERTON",
"state": "RI",
"postal_code": "028784449",
"telephone_number": "401-624-3503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1822 N MAIN ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "02720",
"telephone_number": "508-678-1425",
"fax_number": "508-678-1496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBERG",
"first_name": "JASON",
"middle_name": "KYLE",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "RI",
"license": "PT01932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI LIC",
"identifier": "PT01932",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.