Individual provider Active NPI

Kristen Michelle Masterson, DPT

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1861077067
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10587 Issued in SC
Practice address
1504 Carolna Place Dr Ste 114
Fort Mill, SC 29708-7058
Phone
(803) 349-3449
Fax
(803) 753-8476
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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 10587 SC Primary

Addresses

Primary practice location

1504 Carolna Place Dr Ste 114
Fort Mill, SC 29708-7058

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other names 1

  • Kristen Michelle Masterson Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305000944 SC Practitioner - Physical Therapist in Private Practice 3779065016 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

1504 Carolina PL
Suite 114
Fort Mill, SC 29708-7058
Phone (803) 349-3449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Georgialina Physical Therapy Associates LLC Physical Therapist CurrentSince Mar 16, 2021 Accepting new patients
Athletico LTD Physical Therapist PastSince Mar 16, 2021 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1504 Carolna Place Dr
Ste 114
Fort Mill, SC 29708
Phone (803) 349-3449

Interoperability endpoints

  • Direct secure messaging: kristen.masterson.p12@direct.athleticoltd.nextgenshare.com

Organizations & group practices 2

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1861077067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 CAROLNA PLACE DR STE 114",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297087058",
            "telephone_number": "803-349-3449",
            "fax_number": "803-753-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MASTERSON",
            "middle_name": "MICHELLE",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.