Garrett Thomas Kieffer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

306413 Issued in CA

Practice address

210 W Pine St
Lodi, CA 95240-2020

Phone

(209) 365-7867

NPI assigned

Aug 6, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Golden Bear Physical Therapy Sports Injury Center, Inc

  • Physical Therapy Clinic/Center
  • Modesto, CA
  • NPI 1811084676

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Sutter Gould Medical Foundation

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1326093360
  NPD (past)

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1730919598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-365-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-365-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEFFER",
        "first_name": "GARRETT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdallah Khourdaji, MD
• Ayad Khourdaji, M.D.
• Sophany Khuth
• Valerie J. Kidd, M.D.
• Kids Therapy 4 Success
• Matthew Kim, DDS
• Robert Kim, MD
• Veronica Kimoto
• Rebecca Kinney
• Rena Yvonne Kiraly, NP

• Physical Therapist in Lodi, CA
• Providers in Lodi, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.