Individual provider Active NPI

Kyle D. Memmott, MPT

  • Physical Therapist
  • Mesquite, NV
National Provider Identifier
1659452183
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1828 Issued in NV
Practice address
340 Falcon Ridge Pkwy
#500
Mesquite, NV 89027-8850
Phone
(702) 346-3105
Fax
(702) 346-3544
NPI assigned
Oct 18, 2006
Last updated
Aug 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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 1828 NV Primary

Addresses

Primary practice location

340 Falcon Ridge Pkwy
#500
Mesquite, NV 89027-8850

Mailing address

340 Falcon Ridge Pkwy
#500
Mesquite, NV 89027-8850
Phone (702) 346-3105

Other identifiers 1

IdentifierTypeStateIssuer
100504542MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000918 NV Practitioner - Physical Therapist in Private Practice 2264498948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marchant Physical Therapy and Wellness IncGroup PAC ID 5890693055, 18 clinicians

Practice addresses (Care Compare)

340 Falcon Ridge Pkwy
Suite 500
Mesquite, NV 89027-8850
Phone (702) 346-3100

Merit-based Incentive Payment System (MIPS)

Final score
63.42 of 100Reported as group
Quality
45.41
Improvement activities
40
Cost
78.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marchant Physical Therapy & Wellness, Inc. Physical Therapist CurrentSince Feb 2, 2009 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Mesa View Physical Rehabilitation, LLC PastSince Sep 6, 2010 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

340 Falcon Ridge Pkwy
#500
Mesquite, NV 89027
Phone (702) 346-3100

Organizations & group practices 6

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1659452183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 FALCON RIDGE PKWY",
            "address_2": "#500",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278850",
            "telephone_number": "702-346-3105",
            "fax_number": "702-346-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 FALCON RIDGE PKWY",
            "address_2": "#500",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278850",
            "telephone_number": "702-346-3105",
            "fax_number": "702-346-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMMOTT",
        "first_name": "KYLE",
        "middle_name": "D.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504542",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.