Active NPI
Kota Blaise Reichert, DPT, CSCS
- Physical Therapist
- Stanford, CA
National Provider Identifier
1962711515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 34782
- Practice address
- 300 Pasteur Drive
H3124, M/C5284
Stanford, CA 94305 - Phone
- (650) 498-6433
- NPI assigned
- Sep 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 34782 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Drive
H3124, M/C5284
Stanford, CA 94305
Mailing address
2 Kofman CT.
Alameda, CA 94502
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34782 | CA | MD | Occupational Health Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1962711515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 KOFMAN CT.",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "94502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DRIVE",
"address_2": "H3124, M/C5284",
"city": "STANFORD",
"state": "CA",
"postal_code": "94305",
"telephone_number": "650-498-6433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REICHERT",
"first_name": "KOTA",
"middle_name": "BLAISE",
"credential": "DPT, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-30",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "34782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.