Kimberly L Pentecost, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62787 Issued in OR

Practice address

1630 SW Morrison St Ste 100
Portland, OR 97205-1916

Phone

(503) 227-7774

Fax

(503) 227-7548

NPI assigned

Nov 8, 2018

Sex

Female

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

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KJB Consulting CorporationGroup PAC ID 1759504590, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• KJB Consulting Corporation

  dba Whole Body Health Physical Therapy

  • Physical Therapy Clinic/Center
  • Portland, OR
  • NPI 1497172373

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1891263729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 SW MORRISON ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051916",
            "telephone_number": "503-227-7774",
            "fax_number": "503-227-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SW MORRISON ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051916",
            "telephone_number": "503-227-7774",
            "fax_number": "503-227-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTECOST",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Penny
• Hannah Penrod
• Adam Blaine Penrose, MD
• Joe Richard Pense, QMHA, CADC 1
• Jeffrey Owen Pentecost, D.O.
• Pentimento, Inc.
• Raj Penumetsa, MD
• People'S Health Initiative Counseling Services, LLC
• James Peoples
• Kimberly Peoro, PA-C

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.