Individual provider Active NPI

Kristen Chavis Brommer, DPT

  • Physical Therapist
  • Fayetteville, NC
National Provider Identifier
1891274544
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P18273 Issued in NC
Practice address
1289 Oliver St
Fayetteville, NC 28304-4450
Phone
(910) 483-8331
Fax
(910) 483-8335
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 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 P18273 NC Primary

Addresses

Primary practice location

1289 Oliver St
Fayetteville, NC 28304-4450

Mailing address

1289 Oliver St
Fayetteville, NC 28304-4450
Phone (910) 483-8331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210000733 NC Practitioner - Physical Therapist in Private Practice 3678817277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Jul 8, 2018 Accepting new patients
Pediatric Developmental Therapy Past Accepting new patients
Pediatric Developmental Therapy Physical Therapist Past Accepting new patients

Locations

1801 Olive Chapel Rd
Ste 103
Apex, NC 27502
Phone (919) 373-5353

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

Organizations & group practices 3

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1891274544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMMER",
        "first_name": "KRISTEN",
        "middle_name": "CHAVIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P18273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.