Individual provider Active NPI

Kevin Mark Naugle, PT

  • Physical Therapist
  • Altoona, PA
National Provider Identifier
1720073265
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007524L Issued in PA
Practice address
3200 Fairway Dr
Altoona, PA 16602-4458
Phone
(814) 941-7708
Fax
(814) 941-7715
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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 PT007524L PA Primary

Addresses

Primary practice location

3200 Fairway Dr
Altoona, PA 16602-4458

Mailing address

310 Penn St
Suite 103
Hollidaysburg, PA 16648-2044
Phone (814) 695-2923

Other identifiers 2

IdentifierTypeStateIssuer
848239OtherPAHIGHMARK
650021198OtherPARR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000281 PA Practitioner - Physical Therapist in Private Practice 3971534256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Procare PT LPGroup PAC ID 3476790767, 17 clinicians

Practice addresses (Care Compare)

2825 Earlystown Rd
Centre Hall, PA 16828-9108
Phone (814) 364-3290

3200 Fairway Dr
Altoona, PA 16602-4458
Phone (814) 941-7708

7448 Woodbury Pike
Roaring Spring, PA 16673-1600
Phone (814) 224-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Care Health Systems Inc Past Accepting new patients
Encompass Health Rehabilitation Hospital of Altoona, LLC Past Accepting new patients
The Physical Therapy Institute Past Accepting new patients

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1720073265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PENN ST",
            "address_2": "SUITE 103",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166482044",
            "telephone_number": "814-695-2923",
            "fax_number": "814-695-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 FAIRWAY DR",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024458",
            "telephone_number": "814-941-7708",
            "fax_number": "814-941-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUGLE",
        "first_name": "KEVIN",
        "middle_name": "MARK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT007524L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "848239",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650021198",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.