Active NPI
Kiel Munger
- Physical Therapist
- Mesa, AZ
National Provider Identifier
1780133660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12466
- Practice address
- 4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418 - Phone
- (480) 503-2373
- Fax
- (480) 782-5213
- NPI assigned
- Oct 3, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12466 | AZ | Primary |
Addresses
Primary practice location
4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418
Mailing address
4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418
Phone (480) 503-2373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12466 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1780133660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4210 E BASELINE RD STE 106",
"city": "MESA",
"state": "AZ",
"postal_code": "852064418",
"telephone_number": "480-503-2373",
"fax_number": "480-782-5213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 E BASELINE RD STE 106",
"city": "MESA",
"state": "AZ",
"postal_code": "852064418",
"telephone_number": "480-503-2373",
"fax_number": "480-782-5213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNGER",
"first_name": "KIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-03",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "12466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.