Look up the most recent NPI and PECOS records

Kevin C Axtman

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Kevin C Axtman does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1649298555
Provider Type
Individual
Full Name
Axtman, Kevin C
Title
Mr.
Credential
PT

Gender
Male
Sole Proprietor
No
Enumeration Date
7/18/2006
Last Updated
7/9/2007

Contact Information

Practice Location

310 N 9th St, Bismarck, ND 58501-4508

(701) 530-8800

(701) 530-8763

Mailing Location

310 N 9th St, Bismarck, ND 58501-4508

(701) 530-8800

(701) 530-8763

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 514 North Dakota

Provider Identifiers

ID	Description	Issuer
ID 54971	Description Medicaid	Issuer Unlisted North Dakota

Kevin C Axtman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Scherr, Chelsie

Moser, Ross

Hulstrand, Julie Ann

Gray, Dorothea

Kristensen, Carissa

Harms, Shannon L

Thunshelle, Terry Lee

Herr, Tana J

Allen, Donald Leroy

Fercho, Blaine