Kellen Goertzen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3957 Issued in NE

Practice address

310 E Gold Coast Rd
Ste 113
Papillion, NE 68046

Phone

(402) 504-6506

Fax

(402) 504-6509

NPI assigned

May 15, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

84.65 of 100Reported as group

Quality

84.45

Improvement activities

40

Cost

71.43

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/efffdd49-80a8-4c46-87e6-e53d54707ef3/

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.

• Edge Rehabilitation & Wellness LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1770852006
  Medicare reassignment NPD
• Nebraska Orthopaedic Hospital LLC

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356345318
  NPD (past)
• Rea Rehabilitation Services Inc

  dba Edge Rehabilitation & Wellness

  • Rehabilitation Clinic/Center
  • Colorado Springs, CO
  • NPI 1386719052
  NPD (past)
• Rocky Mountain Rehabilitation P.C.

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1265584494
  NPD (past)

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1639557101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13809 INDUSTRIAL RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68137",
            "telephone_number": "402-932-7111",
            "fax_number": "402-932-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E GOLD COAST RD",
            "address_2": "STE 113",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68046",
            "telephone_number": "402-504-6506",
            "fax_number": "402-504-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERTZEN",
        "first_name": "KELLEN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-15",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1259107",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina M Glover
• Sophia Glover
• Cynthia K Glynn
• Goeken Eye Care, LLC
• Jacqueline Goeppner
• Nichole Gold, OTD/OTR/L
• Rene Elizabeth Gold
• Anna Goldberg, O.D.
• Tiffany Dawn Golka, SLP
• Garang Aguto Gong

• Physical Therapist in Papillion, NE
• Providers in Papillion, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.