Individual provider Active NPI

Kensey Case Bermingham, DPT

  • Physical Therapist
  • Benton Harbor, MI
National Provider Identifier
1144564881
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016121 Issued in MI
Practice address
501 Graham Ave
Benton Harbor, MI 49022-3626
Phone
(574) 850-6638
Fax
(269) 934-5054
NPI assigned
Nov 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 5501016121 MI Primary

Addresses

Primary practice location

501 Graham Ave
Benton Harbor, MI 49022-3626

Mailing address

3138 Oak LN
Stevensville, MI 49127
Phone (574) 850-6638

Other practice location 1

1176 Gernaat Ct Ste B
Portage, MI 49002-3670
Phone (574) 850-6638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130326000594 MI Practitioner - Physical Therapist in Private Practice 0547405300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
RX Physical Therapy PLCGroup PAC ID 1759654221, 6 clinicians

Practice addresses (Care Compare)

501 Graham Ave
Benton Harbor, MI 49022-3626
Phone (269) 769-6108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144564881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3138 OAK LN",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "49127",
            "telephone_number": "574-850-6638",
            "fax_number": "269-934-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GRAHAM AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490223626",
            "telephone_number": "574-850-6638",
            "fax_number": "269-934-5054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1176 Gernaat Ct Ste B",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490023670",
            "country_code": "US",
            "telephone_number": "574-850-6638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMINGHAM",
        "first_name": "KENSEY",
        "middle_name": "CASE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.