NPIMap

Organization Active NPI

Kyle D Guidry

Doing business as Guidry Physical Therapy

  • Occupational Therapist
  • Surprise, AZ
National Provider Identifier
1194088476
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3243 Issued in AZ
Legal business name
KYLE D GUIDRY
Doing business as
Guidry Physical Therapy
Practice address
15949 N Cristine LN
Surprise, AZ 85388-1292
Phone
(623) 518-2127
Fax
(623) 518-2127
NPI assigned
Jun 21, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Mr. Kyle David Guidry, PT, DPT, ATCNPI 1336181569
Title
Owner
Phone
(623) 760-6356

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6398 AZ
Occupational Therapist 225X00000X 3243 AZ Primary

Addresses

Primary practice location

15949 N Cristine LN
Surprise, AZ 85388-1292

Mailing address

16572 W Greenway Rd
Suite 103
Surprise, AZ 85388-2183
Phone (623) 584-3400

Other names 1

  • Guidry Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120719000585 AZ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7618133661 Receives reassigned benefits from 3 practitioners
Practice locations: Surprise, AZ

National Provider Directory

National Provider Directory

Locations

16572 W Greenway Rd
Ste 103
Surprise, AZ 85388
Phone (623) 584-3400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1194088476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16572 W GREENWAY RD",
            "address_2": "SUITE 103",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853882183",
            "telephone_number": "623-584-3400",
            "fax_number": "623-584-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15949 N CRISTINE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853881292",
            "telephone_number": "623-518-2127",
            "fax_number": "623-518-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE D GUIDRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "GUIDRY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-760-6356",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, DPT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6398",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guidry Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.