Individual provider Active NPI

Clint Richard Kalbach, DPT

  • Physical Therapist
  • Monterey, VA
National Provider Identifier
1013142652
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205933 Issued in VA
Practice address
120 Jackson River Rd
Monterey, VA 24465-2416
Phone
(540) 468-6400
Fax
(540) 468-3301
NPI assigned
May 27, 2009
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2305205933 VA
Physical Therapist 225100000X 2305205933 VA Primary

Addresses

Primary practice location

120 Jackson River Rd
Monterey, VA 24465-2416

Mailing address

PO Box 490
Monterey, VA 24465-0490
Phone (540) 247-1751

Other identifiers 1

IdentifierTypeStateIssuer
2305205933OtherVAVIRGINIA STATE PHYSICAL THERAPY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200225002489 VA Practitioner - Physical Therapist in Private Practice 1557798998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Medical Center IncGroup PAC ID 1759285075, 9 clinicians

Practice addresses (Care Compare)

120 Jackson River Rd
Monterey, VA 24465-2416
Phone (540) 468-6402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305205933VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Medical Center Inc CurrentSince Jan 6, 2020 Accepting new patients
Highland Medical Center Inc CurrentSince Jan 6, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15976/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/26465/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBJFAA/Endpoint/CBJFAA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1013142652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MONTEREY",
            "state": "VA",
            "postal_code": "244650490",
            "telephone_number": "540-247-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 JACKSON RIVER RD",
            "city": "MONTEREY",
            "state": "VA",
            "postal_code": "244652416",
            "telephone_number": "540-468-6400",
            "fax_number": "540-468-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALBACH",
        "first_name": "CLINT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305205933",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE PHYSICAL THERAPY LICENSE",
            "identifier": "2305205933",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.