Kyle L Greenawalt, MSPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT019355 Issued in PA

Practice address

2655 Woodglen Rd
Pottsville, PA 17901-1335

Phone

(570) 622-6648

NPI assigned

Jul 3, 2008

Last updated

Jul 3, 2008By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1801059506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 WOODGLEN RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179011335",
            "telephone_number": "570-622-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 WOODGLEN RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179011335",
            "telephone_number": "570-622-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAWALT",
        "first_name": "KYLE",
        "middle_name": "L",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "PT019355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher D Goodman, CPHT, CSPT
• Heather Gosch, C.N.M.
• Holly Gotshall
• Robert M Greco, M.D.
• Charles E Green, M.D.
• Trudy Lynn Greene, LPC
• Julianne C Grega, PA-C
• Carly Gregas
• Patricia Gregas, OTR
• Pamela J. Gressens, CRNP

• Physical Medicine & Rehabilitation Physician in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.