Kristin Leigh Clyde, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015517 Issued in PA

Practice address

273 Route 288
Ellwood City, PA 16117-3055

Phone

(724) 758-7044

Fax

(724) 752-6845

NPI assigned

Dec 22, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristin Leigh Freshcorn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1962867721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 ROUTE 288",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161173055",
            "telephone_number": "724-758-7044",
            "fax_number": "724-752-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 ROUTE 288",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161173055",
            "telephone_number": "724-758-7044",
            "fax_number": "724-752-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "KRISTIN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "FRESHCORN",
            "middle_name": "LEIGH",
            "prefix": "MISS",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin Casas-Cordero Marambio
• Lexie R Cearfoss
• Christopher James Chill, P.T.
• Jennifer Earl Chill, P.T.
• Christopher a Panek DPM PC
• Anthony Baron Colangelo, M.D.
• Cassandra Cook
• Kala Cunningham, MA, LPC
• Kelley M Davis, BSAT, ATC
• Mary Joe Davis, M.A., L.P.C.

• Physical Therapist in Ellwood City, PA
• Providers in Ellwood City, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.