Individual provider Active NPI

Kira Sade Fitchpatrick, PT, DPT

  • Physical Therapist
  • Bartlett, TN
National Provider Identifier
1053877001
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12617 Issued in TN
Practice address
3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone
(901) 937-3200
Fax
(901) 383-1738
NPI assigned
Feb 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6618 MS
Physical Therapist 225100000X 12617 TN Primary

Addresses

Primary practice location

3045 Kate Bond Rd
Bartlett, TN 38133-4004

Mailing address

2670 McIngvale Rd Ste J
Hernando, MS 38632-8696
Phone (901) 641-3000

Other practice location 1

5225 Highway 18 W Ste C
Jackson, MS 39209-9447
Phone (601) 487-8456

Other practice location 2

2670 McIngvale Rd Ste J
Hernando, MS 38632-8696
Phone (901) 641-3000

Other names 1

  • Kira Sade Scott Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201130001269 TN Practitioner - Physical Therapist in Private Practice 4385055144 Reassigns benefits to 1 organization
I20210623000045 MS Practitioner - Physical Therapist in Private Practice 4385055144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4857 Goodman Rd
Suite 106
Olive Branch, MS 38654-7916
Phone (662) 880-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group PC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
MSK Group, PC Physical Therapist CurrentSince Dec 7, 2020 Accepting new patients
K Fit Physical Therapy, LLC Physical Therapist CurrentSince Oct 5, 2023 Accepting new patients
MSK Group, PC Physical Therapist CurrentSince Dec 7, 2020 Accepting new patients
Physical Therapy First LLC Physical Therapist PastSince Sep 25, 2017 Accepting new patients

Locations

2670 McIngvale Rd
Ste J
Hernando, MS 38632
Phone (662) 548-2710

4857 Goodman Rd
Ste 106
Olive Branch, MS 38654
Phone (601) 750-7252

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

3045 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 381-4664

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 5

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": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1053877001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 MCINGVALE RD STE J",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328696",
            "telephone_number": "901-641-3000",
            "fax_number": "017-012-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 KATE BOND RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334004",
            "telephone_number": "901-937-3200",
            "fax_number": "901-383-1738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 Highway 18 W Ste C",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392099447",
            "country_code": "US",
            "telephone_number": "601-487-8456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2670 McIngvale Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Hernando",
            "state": "MS",
            "postal_code": "386328696",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "017-012-4289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITCHPATRICK",
        "first_name": "KIRA",
        "middle_name": "SADE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6618",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRA",
            "last_name": "SCOTT",
            "middle_name": "SADE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.