Kristen Mie Berryman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60139732 Issued in WA

Practice address

4455 148TH Avenue NE
Bellevue, WA 98007

Phone

(425) 861-6255

Fax

(425) 869-5285

NPI assigned

Aug 26, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kristen Mie Kimoto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Makai Mobile Rehab, LLC

  • Physical Therapy Clinic/Center
  • Honolulu, HI
  • NPI 1265326953
  NPD

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1881827681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 148TH AVENUE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98007",
            "telephone_number": "425-861-6255",
            "fax_number": "425-869-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 148TH AVENUE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98007",
            "telephone_number": "425-861-6255",
            "fax_number": "425-869-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRYMAN",
        "first_name": "KRISTEN",
        "middle_name": "MIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8633",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60139732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "KIMOTO",
            "middle_name": "MIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Bernhardt
• Kristin P Bernhart, MD
• Anthony Bernicchi, MD
• Madeline Anne Berry, LICSW
• Madeline Therese Berry, LMFTA
• Robert M Bersin, MD, M.P.H
• Rebecca Erin Berzins, LMHC
• Emily Besaw, LICSW
• Beshewa Consultant and Educator PLLC
• Mary A Beskar

• Physical Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.