Individual provider Active NPI

Kristen Mary Martinez, PT, DPT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1659077105
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21959 Issued in NC
Practice address
9908 Couloak Dr Ste 100
Charlotte, NC 28216-8678
Phone
(704) 801-3065
NPI assigned
Feb 6, 2023
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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 P21959 NC Primary

Addresses

Primary practice location

9908 Couloak Dr Ste 100
Charlotte, NC 28216-8678

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230323003169 NC Practitioner - Physical Therapist in Private Practice 5395119887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health Specialty Network IncGroup PAC ID 5193245801, 248 clinicians

Practice addresses (Care Compare)

4525 Cameron Valley Pkwy
Charlotte, NC 28211-4369
Phone (704) 468-8874

9908 Couloak Dr
Suite 100
Charlotte, NC 28216-8678
Phone (704) 801-3065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC CurrentSince Feb 13, 2023 Accepting new patients
Atrium Health Specialty Network Inc Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Feb 13, 2023 Accepting new patients
Cleveland Physical Therapy Associates Inc PastSince Feb 1, 2023 Accepting new patients

Locations

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

9908 Couloak Dr
Ste 100
Charlotte, NC 28216
Phone (704) 801-3065

110 W King St
Ste 9
Kings Mountain, NC 28086
Phone (704) 471-0001

836 E King St
Kings Mountain, NC 28086
Phone (704) 739-5995

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1659077105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9908 COULOAK DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168678",
            "telephone_number": "704-801-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KRISTEN",
        "middle_name": "MARY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.