Active NPI
Kevyn L Soupiset, PT
- Physical Therapist
- Larned, KS
National Provider Identifier
1932110863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-03072
- Practice address
- 117 W 6TH St
Larned, KS 67550-3045 - Phone
- (620) 285-6011
- Fax
- (620) 285-6012
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-03072 | KS | Primary |
Addresses
Primary practice location
117 W 6TH St
Larned, KS 67550-3045
Mailing address
338 Sunset Rd
Great Bend, KS 67530-9255
Phone (620) 285-6011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200547290A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-03072 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Therapy & Sports Med., LLC | Past | Accepting new patients | |
| Achieve Rehab, LLC | Physical Therapist | Past | Accepting new patients |
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.
-
dba Advanced Therapy & Sports Medicine
- Physical Therapy Clinic/Center
- Great Bend, KS
- NPI 1679036206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1932110863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "338 SUNSET RD",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675309255",
"telephone_number": "620-285-6011",
"fax_number": "620-285-6012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 W 6TH ST",
"city": "LARNED",
"state": "KS",
"postal_code": "675503045",
"telephone_number": "620-285-6011",
"fax_number": "620-285-6012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUPISET",
"first_name": "KEVYN",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-03072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200547290A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Larned, KS
- Marissa Leigh Smith
- Trent D Smith
- Ruthann Snodgrass, LSCSW, LCAC
- Tabatha Jeanette Snyder, PHARM.D.
- Karen Brown Soden, ARNP
- St Joseph Memorial Hospital Inc
- St. Joseph Memorial Hospital, Inc. (St Joseph Family Medicine-Larned)
- St. Joseph Memorial Hospital, Inc. (St. Joseph Family Medicine - Larned)
- Ruth Staats, RN
- State of Kansas-Accounting Services (Larned State Hospital)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.