Active NPI
Brandon M Kiser, PT, DPT
- Physical Therapist
- Fruita, CO
National Provider Identifier
1780953992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2657
- Practice address
- 300 W Ottley Ave
Fruita, CO 81521-2118 - Phone
- (970) 858-2147
- NPI assigned
- Dec 16, 2011
- Last updated
- Sep 11, 2023
- 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 | 2657 | NE | Primary |
Addresses
Primary practice location
300 W Ottley Ave
Fruita, CO 81521-2118
Mailing address
300 W Ottley Ave
Fruita, CO 81521-2118
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2657 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1780953992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W OTTLEY AVE",
"city": "FRUITA",
"state": "CO",
"postal_code": "815212118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W OTTLEY AVE",
"city": "FRUITA",
"state": "CO",
"postal_code": "815212118",
"telephone_number": "970-858-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISER",
"first_name": "BRANDON",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-16",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fruita, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.