Individual provider Active NPI

Kevin M. Sowvlen, PTA

  • Physical Therapy Assistant
  • San Diego, CA
National Provider Identifier
1629217005
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT-4714 Issued in CA
Practice address
16148 Cayenne Creek Rd
San Diego, CA 92127-3709
Phone
(858) 312-1971
NPI assigned
Feb 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT-4714 CA Primary

Addresses

Primary practice location

16148 Cayenne Creek Rd
San Diego, CA 92127-3709

Mailing address

16148 Cayenne Creek Rd
San Diego, CA 92127-3709
Phone (858) 312-1971

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT-4714CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1629217005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16148 CAYENNE CREEK RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273709",
            "telephone_number": "858-312-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16148 CAYENNE CREEK RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273709",
            "telephone_number": "858-312-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOWVLEN",
        "first_name": "KEVIN",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT-4714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.