Individual provider Active NPI

Kristine Danielle Cleveland

  • Physical Therapist
  • Smithfield, NC
National Provider Identifier
1770185092
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P19991 Issued in NC
Practice address
1317-A N. Brightleaf Blvd.
Smithfield, NC 27577-7267
Phone
(919) 300-5040
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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 P19991 NC Primary

Addresses

Primary practice location

1317-A N. Brightleaf Blvd.
Smithfield, NC 27577-7267

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Other names 1

  • Kristine Danielle Christiansen Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118003327 NC Practitioner - Physical Therapist in Private Practice 2062823255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

1417 S Pollock St
Selma, NC 27576-3405
Phone (919) 300-5040

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
85.21
Promoting interoperability
99
Improvement activities
40
Cost
77.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Sep 26, 2023 Accepting new patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC Physical Therapist CurrentSince Sep 26, 2023 Accepting new patients
Proptnc,LLC Physical Therapist CurrentSince Jul 7, 2026 Accepting new patients

Locations

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

1165 E Cumberland St
Ste 126
Dunn, NC 28334
Phone (910) 241-4085

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

1417 S Pollock St
Selma, NC 27576
Phone (919) 300-5040

112 Walmart Supercenter
Siler City, NC 27344
Phone (919) 799-2216

1317 N Brightleaf Blvd
Ste A
Smithfield, NC 27577
Phone (516) 220-5410

Interoperability endpoints

  • Direct secure messaging: kristine.cleveland.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": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1770185092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317-A N. BRIGHTLEAF BLVD.",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275777267",
            "telephone_number": "919-300-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "KRISTINE",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "CHRISTIANSEN",
            "middle_name": "DANIELLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.