Kinport Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

KINPORT PHYSICAL THERAPY

Practice address

920 Deon Dr
Pocatello, ID 83201-3069

Phone

(207) 446-5994

NPI assigned

Nov 17, 2021

Organization subpart

No

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

Authorized official

Name

Bryan Lawson, DPTNPI 1639739022

Title

Owner

Phone

(207) 446-5994

Specialties & licenses 1

Addresses

Other names 1

• Kinport PT Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Philip Lawson, PT

  • Physical Medicine & Rehabilitation Physician
  • Pocatello, ID
  • NPI 1639739022

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Brock Edward Hulsey, PT

  • Physical Therapist
  • Pocatello, ID
  • NPI 1447816442
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1740947472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DEON DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DEON DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013069",
            "telephone_number": "207-446-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINPORT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-446-5994",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinport PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Moon Joo Kim, MD
• Kimberly B Rasmussen, PLLC
• Elisabeth Gayle Kinghorn, P.A.
• Gilson Peter Kingman
• Zachary Kinney, RECOVERY COACH
• Melissa Kjos, M.D.
• Rebecca L Klingler, PMHNP
• Steven R Klitgaard, PT
• Daniel M Knapp, LCSW
• Derek Curt Knapp, DPM

• Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.