Patrick Lyle King, PT, DPT, MSC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11667 Issued in MN

Practice address

1625 Radio Dr Ste 220
Woodbury, MN 55125-9476

Phone

(651) 241-3636

Fax

(651) 241-3646

NPI assigned

Jan 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tria Orthopaedic Center LLC

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1518273085

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD

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

{
    "created_epoch": "1577836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1104465632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6562 JANERO BAY S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550162377",
            "telephone_number": "651-755-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 RADIO DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259476",
            "telephone_number": "651-241-3636",
            "fax_number": "651-241-3646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 State Ave",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550216368",
            "country_code": "US",
            "telephone_number": "507-497-3790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "PATRICK",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-01",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget M Kimker, PA-C
• Kind Heart Helpers Inc
• Kinecio
• Kinetic Physical Therapy Institute
• Funsho King
• Sierra King
• Georgie L Kinlaw
• Christina M Kinney, OD
• George J Kinney, Jr., D.D.S.
• Renee M Kinney, DDS

• Physical Therapist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.