Individual provider Active NPI

Laura Ann Kinsley, PT

  • Physical Therapist
  • Port Huron, MI
National Provider Identifier
1104103928
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015709 Issued in MI
Practice address
940 River Centre Dr
Port Huron, MI 48060-4463
Phone
(810) 985-4900
Fax
(810) 985-3634
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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 5501015709 MI Primary

Addresses

Primary practice location

940 River Centre Dr
Port Huron, MI 48060-4463

Mailing address

940 River Centre Dr
Port Huron, MI 48060-4463
Phone (810) 985-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000922 MI Practitioner - Physical Therapist in Private Practice 0042486243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munger Physical Therapy PLCGroup PAC ID 6204906852, 6 clinicians

Practice addresses (Care Compare)

4351 24TH Ave
Fort Gratiot, MI 48059-4506
Phone (810) 385-7405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015709MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Munger Physical Therapy, PLC Physical Therapist CurrentSince Mar 3, 2014 Accepting new patients
Orthopedic Associates of Port Huron PC Past Accepting new patients
Munger Physical Therapy of Clinton Township, PLC Physical Therapist PastSince Aug 10, 2019 Accepting new patients

Locations

44925 Morley Dr
Clinton Twp, MI 48036
Phone (586) 846-4320

4351 24th Ave
Ste 1
Fort Gratiot, MI 48059
Phone (810) 385-7405

4351 24th Ave
Ste 5
Fort Gratiot, MI 48059
Phone (810) 385-7405

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD

Organizations & group practices 3

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1104103928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSLEY",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.