Individual provider Active NPI

Tamara Elisa Kefeyan, MPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1700423431
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15942 Issued in MA
Practice address
2701 Chestnut Station CT
Louisville, KY 40299-6395
Phone
(800) 335-1060
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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 15942 MA Primary

Addresses

Primary practice location

2701 Chestnut Station CT
Louisville, KY 40299-6395

Mailing address

98 Farnham St
Belmont, MA 02478-3178
Phone (617) 775-3514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15942MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1700423431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 FARNHAM ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783178",
            "telephone_number": "617-775-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CHESTNUT STATION CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996395",
            "telephone_number": "800-335-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEFEYAN",
        "first_name": "TAMARA",
        "middle_name": "ELISA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.