NPIMap

Organization Active NPI

PGPT, LLC

Doing business as Fyzical Therapy and Balance Center of Petoskey

  • Physical Therapy Clinic/Center
  • Petoskey, MI
National Provider Identifier
1083456834
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PGPT, LLC
Doing business as
Fyzical Therapy and Balance Center of Petoskey
Practice address
2609 Charlevoix Ave
Petoskey, MI 49770
Phone
(989) 858-5107
NPI assigned
Jun 12, 2024
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Thomas William Kirkby, PTNPI 1942464870
Title
Owner
Phone
(989) 858-5107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

2609 Charlevoix Ave
Petoskey, MI 49770

Mailing address

2609 Charlevoix Ave
Petoskey, MI 49770
Phone (989) 858-5107

Other names 1

  • Fyzical Therapy and Balance Center of Petoskey Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241002003878 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9537690441 Receives reassigned benefits from 1 practitioner
Practice locations: Petoskey, MI

National Provider Directory

National Provider Directory

Locations

2609 Charlevoix Rd
Ste 3
Petoskey, MI 49770

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1083456834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 CHARLEVOIX AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "989-858-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 CHARLEVOIX AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "989-858-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGPT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "KIRKBY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-858-5107",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy and Balance Center of Petoskey",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fyzical Therapy and Balance Center of Petoskey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.