Individual provider Active NPI

Kimberly Green, MPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1952888000
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501009265 Issued in MI
Practice address
2701 Chestnut Station CT
Louisville, KY 40299-6395
Phone
(800) 335-1060
NPI assigned
Jul 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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 5501009265 MI Primary

Addresses

Primary practice location

2701 Chestnut Station CT
Louisville, KY 40299-6395

Mailing address

801 W Long Lake Rd Apt B7
Bloomfield Hills, MI 48302-2061

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501009265MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1532217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1952888000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W LONG LAKE RD APT B7",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483022061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CHESTNUT STATION CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996395",
            "telephone_number": "800-335-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KIMBERLY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-22",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2018; 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.