Active NPI
Kelly Lynn Liebermann, DPT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1629363932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9968
- Practice address
- 3000 New Bern Ave
Raleigh, NC 27610-1231 - Phone
- (919) 350-8950
- NPI assigned
- Jun 15, 2011
- Sex
- Female
- 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 | 9968 | NC | Primary |
Addresses
Primary practice location
3000 New Bern Ave
Raleigh, NC 27610-1231
Mailing address
602 Chapwith Rd
Garner, NC 27529-4895
Phone (919) 452-2631
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 |
|---|---|---|---|
| 9968 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1629363932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 CHAPWITH RD",
"city": "GARNER",
"state": "NC",
"postal_code": "275294895",
"telephone_number": "919-452-2631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101231",
"telephone_number": "919-350-8950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMANN",
"first_name": "KELLY",
"middle_name": "LYNN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-15",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "9968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.