Individual provider Active NPI

Kevin Kucko, PT

  • Physical Therapist
  • Mooresville, NC
National Provider Identifier
1801120639
Registry record updated Sep 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6830 Issued in NC
Practice address
134 Medical Park Rd Ste 105
Mooresville, NC 28117-8527
Phone
(704) 806-9826
NPI assigned
Sep 27, 2009
Last updated
Sep 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2009

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 6830 NC Primary

Addresses

Primary practice location

134 Medical Park Rd Ste 105
Mooresville, NC 28117-8527

Mailing address

20221 Hammock Oak Dr
Cornelius, NC 28031-6813
Phone (704) 806-9826

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110915000001 NC Practitioner - Physical Therapist in Private Practice 0244401636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K-2 Healthcare ConsultingGroup PAC ID 9335310721, 4 clinicians

Practice addresses (Care Compare)

508 Williamson Rd
Suite 200
Mooresville, NC 28117-9186
Phone (704) 360-2595

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
K-2 Healthcare Consulting CurrentSince Jun 8, 2011 Accepting new patients

Locations

508 Williamson Rd
Ste 200
Mooresville, NC 28117
Phone (704) 360-2595

514 Williamson Rd
Ste 431
Mooresville, NC 28117
Phone (704) 360-2595

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254009600000",
    "number": "1801120639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20221 HAMMOCK OAK DR",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316813",
            "telephone_number": "704-806-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 MEDICAL PARK RD STE 105",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178527",
            "telephone_number": "704-806-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCKO",
        "first_name": "KEVIN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-27",
        "last_updated": "2009-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2009; 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.