Individual provider Active NPI

Kathleen Michelle Brinegar, PT, DPT

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1619406436
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05012521A Issued in IN
Practice address
4740 Kingsway Dr
Indianapolis, IN 46205-1521
Phone
(317) 466-1000
NPI assigned
Jun 6, 2017
Last updated
Mar 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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 05012521A IN Primary
Pediatric Physical Therapist 2251P0200X 05012521A IN

Addresses

Primary practice location

4740 Kingsway Dr
Indianapolis, IN 46205-1521

Mailing address

4740 Kingsway Dr
Indianapolis, IN 46205-1521

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
05012521AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1619406436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 KINGSWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 KINGSWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051521",
            "telephone_number": "317-466-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINEGAR",
        "first_name": "KATHLEEN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012521A",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": "05012521A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.