Kevin Laurence Outwater

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT04320 Issued in OH

Legal business name

KEVIN LAURENCE OUTWATER

Doing business as

PT Ctr for Sports Med-Fam Phys Ther

Practice address

2660 W Market St
Ste 300
Fairlawn, OH 44333-4206

Phone

(330) 869-2635

Fax

(330) 869-8315

NPI assigned

Jun 14, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Tina Outwater

Title

Office Manager

Phone

(330) 239-4186

Specialties & licenses 1

Addresses

Other names 1

• PT Ctr for Sports Med-Fam Phys Ther Doing business as

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1679578017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST",
            "address_2": "STE 300",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334206",
            "telephone_number": "330-869-2635",
            "fax_number": "330-869-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST",
            "address_2": "STE 300",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334206",
            "telephone_number": "330-869-2635",
            "fax_number": "330-869-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN LAURENCE OUTWATER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "OUTWATER",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-239-4186",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT04320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PT Ctr for Sports Med-Fam Phys Ther",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Calleiah Kennedy
• Catherine E Kenny, RPH
• Danielle Kern, QMHS BA CMS
• Michael Kesselring, NP
• Kevin Becnel
• Ghassan F Khayyat, MD
• Jill Marie Kiley, LPN
• Rebecca Grace Kilmer
• Jennifer Dasol Kim, DDS
• Kindred Spirit Behavioral Health

• Physical Therapist in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.