Kristen Davenport, PT, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1276281 Issued in TX

Practice address

413 W Bethel Rd Ste 400
Coppell, TX 75019-4477

Phone

(972) 304-9100

Fax

(972) 304-9048

NPI assigned

Sep 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristen Klittich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Base Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • Argyle, TX
  • NPI 1023705027
  NPD Authorized official
• Coppell Spine & Sports Rehab Limited Partnership

  • Physical Therapy Clinic/Center
  • Coppell, TX
  • NPI 1669490629
  NPD (past)

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1629479142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750198607",
            "telephone_number": "972-724-2400",
            "fax_number": "972-724-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W BETHEL RD STE 400",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194477",
            "telephone_number": "972-304-9100",
            "fax_number": "972-304-9048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 S Soncy Rd Ste 137",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "79119",
            "country_code": "US",
            "telephone_number": "806-331-6084",
            "fax_number": "806-331-6085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "KRISTEN",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41640",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1276281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "KLITTICH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rauna Dallman, PT
• Bridget Dalton
• Christopher Dao
• Madeleine Dao
• Anindita Das
• Melissa Davis, FNP-C
• Trumon D Davis, DDS
• Hannah Marie Davison
• Davita RX, LLC
• Cassandra Mae Dawley, DPT

• Physical Therapist in Coppell, TX
• Providers in Coppell, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.