Michael Anthony Kidwell, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006742 Issued in KY

Practice address

708 Westport Rd
200
Elizabethtown, KY 42701-3819

Phone

(270) 766-1213

Fax

(270) 766-1115

NPI assigned

Nov 5, 2015

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kentucky Orthopedic Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Richmond, KY
  • NPI 1295477248
  NPD (past)
• Kentucky Orthopedic Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Lexington, KY
  • NPI 1730189762

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1144693631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 WESTPORT RD",
            "address_2": "200",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013819",
            "telephone_number": "270-766-1213",
            "fax_number": "270-766-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 WESTPORT RD",
            "address_2": "200",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013819",
            "telephone_number": "270-766-1213",
            "fax_number": "270-766-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Key
• Syed Abdul Khader, DPM
• Khan Radiology Services PLLC
• Saleena Khanna, MD
• Kidney Specialists of Kentucky
• Kim Sego Tully, LCSW, Psychotherapy Services
• Michael Keith Kimble, DDS
• Kasey Kindervater, APRN
• Kindred Grove Counseling LLC
• Ashley King-Tinsley, DMD

• Physical Therapist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.