Individual provider Active NPI

Kiran Kotu, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1639455207
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2694 Issued in NE
Practice address
1540 N 72ND St
Omaha, NE 68114-1924
Phone
(402) 398-3958
NPI assigned
Oct 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2694 NE Primary

Addresses

Primary practice location

1540 N 72ND St
Omaha, NE 68114-1924

Mailing address

7009 S Harrison Hills Dr
Apt-207
La Vista, NE 68128-7710
Phone (317) 529-2978

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

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1639455207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7009 S HARRISON HILLS DR",
            "address_2": "APT-207",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681287710",
            "telephone_number": "317-529-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 N 72ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141924",
            "telephone_number": "402-398-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTU",
        "first_name": "KIRAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.