Individual provider Active NPI

Kristyn Sarah Walker

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1720831993
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P23043 Issued in NC
Practice address
3708 Forestview Rd Ste 101
Raleigh, NC 27612-2391
Phone
(919) 786-7434
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 P23043 NC Primary

Addresses

Primary practice location

3708 Forestview Rd Ste 101
Raleigh, NC 27612-2391

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

738 Newman Rd
New Bern, NC 28562-5238
Phone (252) 633-6099

Other names 1

  • Kristyn Sarah Van Cleave Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626003910 NC Practitioner - Physical Therapist in Private Practice 4385188713 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians Current Accepting new patients
Carolinaeast Physicians CurrentSince Apr 16, 2024 Accepting new patients
Carolinaeast Physicians CurrentSince Apr 16, 2024 Accepting new patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Jan 27, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

738 Newman Rd
New Bern, NC 28562
Phone (252) 633-0361

137 Medical Ln
Pollocksville, NC 28573
Phone (252) 633-1010

3708 Forestview Rd
Ste 101
Raleigh, NC 27612
Phone (919) 786-7434

Interoperability endpoints

  • Direct secure messaging: kristyn.walker.p12@direct.athleticoltd.nextgenshare.com

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1720831993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 FORESTVIEW RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122391",
            "telephone_number": "919-786-7434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "738 Newman Rd",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "285625238",
            "country_code": "US",
            "telephone_number": "252-633-6099",
            "fax_number": "252-633-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KRISTYN",
        "middle_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTYN",
            "last_name": "VAN CLEAVE",
            "middle_name": "SARAH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.