Individual provider Active NPI

Tiffonie Kai Dirks, M.P.T.

  • Physical Therapist
  • Prairie Village, KS
National Provider Identifier
1003958109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2001028698 Issued in MO
Practice address
4127 W 73Rd St
Prairie Village, KS 66208-2928
Phone
(913) 432-1866
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2001028698 MO Primary

Addresses

Primary practice location

4127 W 73Rd St
Prairie Village, KS 66208-2928

Mailing address

4127 W 73Rd St
Prairie Village, KS 66208-2928
Phone (913) 432-1866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140226000524 KS Practitioner - Physical Therapist in Private Practice 2365672011 Reassigns benefits to 1 organization
I20210120003197 MO Practitioner - Physical Therapist in Private Practice 2365672011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arc Physical Therapy Plus LPGroup PAC ID 6204050453, 59 clinicians

Practice addresses (Care Compare)

6362 College Blvd
Overland Park, KS 66211-1506
Phone (913) 754-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2001028698MOMDPhysical Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003958109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4127 W 73RD ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082928",
            "telephone_number": "913-432-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4127 W 73RD ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082928",
            "telephone_number": "913-432-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKS",
        "first_name": "TIFFONIE",
        "middle_name": "KAI",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2001028698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.