Kristen Dabbo

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11261 Issued in SC

Practice address

2045 Copper Creek CT
Myrtle Beach, SC 29579-4175

Phone

(203) 217-7986

NPI assigned

Feb 24, 2014

Last updated

Dec 12, 2022By the provider in NPPES

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 Davis 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reignite Personal Physical Therapy LLC

  • Physical Therapist
  • Myrtle Beach, SC
  • NPI 1477263515
  NPD Authorized official

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1932524253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 COPPER CREEK CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794175",
            "telephone_number": "203-217-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 COPPER CREEK CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794175",
            "telephone_number": "203-217-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABBO",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "10059",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CVS/Pharmacy
• Lisa Cyganiewicz
• Tierney Czapiewski, SLP
• Allison Elizabeth D'Orazio, LPC-A
• Thomas J D'Orazio, M.D., PH.D.
• William J. Daley, M.S.P.T
• Justin Dammann, D.M.D.
• Amy Dangelo, RD, LDN
• Matthew Allen Daniel, DO
• Angela Walls Daniels

• Physical Therapist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.