Individual provider Active NPI

Kyle Christopher Markway, PT

  • Physical Therapist
  • Jefferson City, MO
National Provider Identifier
1154634855
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2024031092 Issued in MO
Practice address
1002 Diamond RDG Ste 800
Jefferson City, MO 65109-7906
Phone
(573) 761-9360
Fax
(573) 761-9362
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 2024031092 MO Primary

Addresses

Primary practice location

1002 Diamond RDG Ste 800
Jefferson City, MO 65109-7906

Mailing address

1002 Diamond RDG Ste 800
Jefferson City, MO 65109-7906
Phone (573) 761-9360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920000657 MO Practitioner - Physical Therapist in Private Practice 9830381698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians
Central Missouri Physical Therapy LLCGroup PAC ID 6901870187, 59 clinicians

Practice addresses (Care Compare)

1002 Diamond RDG
Suite 800
Jefferson City, MO 65109-7906
Phone (573) 761-9360

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone (573) 449-8771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024031092MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Boone Physician Services, LLC CurrentSince Sep 12, 2024 Accepting new patients
Orthotennessee, PC PastSince Aug 1, 2020 Accepting new patients
Hovis Orthopaedic Clinic PC PastSince Aug 1, 2020 Accepting new patients
Orthotennessee Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1002 Diamond Rdg
Ste 800
Jefferson City, MO 65109
Phone (573) 761-9360

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

104 Jack Dance St
Knoxville, TN 37919
Phone (865) 391-8381

4433 Kingston Pike
Knoxville, TN 37919
Phone (865) 602-4242

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kyle.markway.p1@direct.orthotn.nextgenshare.com

Organizations & group practices 6

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1154634855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 DIAMOND RDG STE 800",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651097906",
            "telephone_number": "573-761-9360",
            "fax_number": "573-761-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 DIAMOND RDG STE 800",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651097906",
            "telephone_number": "573-761-9360",
            "fax_number": "573-761-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKWAY",
        "first_name": "KYLE",
        "middle_name": "CHRISTOPHER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2024031092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.