Individual provider Active NPI

Kyle Robert Corrick, PT, DPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1063820223
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26291 Issued in FL
Practice address
2907 W Bay to Bay Blvd
Suite 100
Tampa, FL 33629-8172
Phone
(813) 250-1209
Fax
(813) 250-1209
NPI assigned
Jul 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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 PT26291 FL Primary

Addresses

Primary practice location

2907 W Bay to Bay Blvd
Suite 100
Tampa, FL 33629-8172

Mailing address

2907 W Bay to Bay Blvd
Suite 100
Tampa, FL 33629-8172
Phone (813) 250-1208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26291FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Inc Physical Therapist Past Accepting new patients

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1063820223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 W BAY TO BAY BLVD",
            "address_2": "SUITE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298172",
            "telephone_number": "813-250-1208",
            "fax_number": "813-250-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 W BAY TO BAY BLVD",
            "address_2": "SUITE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298172",
            "telephone_number": "813-250-1209",
            "fax_number": "813-250-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRICK",
        "first_name": "KYLE",
        "middle_name": "ROBERT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.