Individual provider Active NPI

Kirstin Coulombe, PT, DPT

  • Orthopedic Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1699458034
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
13398305-2401 Issued in UT
Practice address
5151 S 900 E Ste 100
Salt Lake City, UT 84117-6658
Phone
(801) 261-3321
NPI assigned
Aug 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 13398305-2401 UT Primary

Addresses

Primary practice location

5151 S 900 E Ste 100
Salt Lake City, UT 84117-6658

Mailing address

6664 S Pines Point Way
West Jordan, UT 84084-1899
Phone (801) 589-6673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925003094 UT Practitioner - Physical Therapist in Private Practice 9234583238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Utah School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hand and Orthopedic Rehabilitation Specialists PCGroup PAC ID 0547252207, 26 clinicians

Practice addresses (Care Compare)

5151 S 900
Suite 100
Salt Lake City, UT 84117-6658
Phone (801) 261-3321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13398305-2401UTMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand & Orthopedic Rehabilitation Specialists PC Current Accepting new patients
Hand & Orthopedic Rehabilitation Specialists PC CurrentSince Aug 14, 2023 Accepting new patients
Hand & Orthopedic Rehabilitation Specialists PC CurrentSince Aug 14, 2023 Accepting new patients
Hand & Orthopedic Rehabilitation Specialists PC Orthopedic Past Accepting new patients

Locations

5151 S 900 E
Ste 100
Murray, UT 84117
Phone (801) 261-3321

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1699458034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6664 S PINES POINT WAY",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840841899",
            "telephone_number": "801-589-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 S 900 E STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841176658",
            "telephone_number": "801-261-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULOMBE",
        "first_name": "KIRSTIN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "13398305-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.