Jerry Kohout Jr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P22811 Issued in NC

Practice address

2024 Olde Regent Way Ste 130
Leland, NC 28451-4250

Phone

(910) 302-3330

Fax

(910) 213-3575

NPI assigned

Sep 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.67 of 100Reported as group

Quality

85.21

Promoting interoperability

99

Improvement activities

40

Cost

77.85

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerry.kohout.p12@direct.athleticoltd.nextgenshare.com

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.

• Activcare Physical Therapy, LLC

  • Clinic/Center
  • Raleigh, NC
  • NPI 1548409626

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Access PT Pennsylvania

  • Physical Therapist
  • Carlisle, PA
  • NPI 1255033254
  NPD
• Access PT Pennsylvania

  • Physical Therapist
  • Mechanicsburg, PA
  • NPI 1316649320
  NPD

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1992474894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "570-550-0168",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 OLDE REGENT WAY STE 130",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284514250",
            "telephone_number": "910-302-3330",
            "fax_number": "910-213-3575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 E Pomfret St",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170132579",
            "country_code": "US",
            "telephone_number": "717-245-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHOUT",
        "first_name": "JERRY",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029822",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.cardinmillerpt.com/",
            "affiliation": "Y",
            "affiliationName": "Mildin Inc",
            "address_1": "290 E Pomfret St",
            "city": "Carlisle",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170132579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kidzcare Pediatrics, PC
• Natalie Knight
• Rachel Adams Knight
• Jackie Koekkoek, MSOM, L AC., LMBT
• Tanis McKenna Kohl
• Kristin Main DDS, PLLC
• Jonathan Richard Lampe
• Jeffrey Lance, FNP-BC
• Kevin Lamont Lane
• Aubrey O'Rourke Lavoie, PHARMD

• Physical Therapist in Leland, NC
• Providers in Leland, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.