Kyle Thibodeaux, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH9337 Issued in AL

Practice address

108 S Florida St
Mobile, AL 36606-1927

Phone

(251) 501-2700

Fax

(251) 501-2701

NPI assigned

Jun 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of South Alabama College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Refine PT and Performance LLCGroup PAC ID 6103164967, 21 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.

• Refine PT and Performance LLC

  • Physical Therapist
  • Daphne, AL
  • NPI 1568930907

  AL, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Refine PT and Performance - East Alabama LLC

  • Physical Therapist
  • Dothan, AL
  • NPI 1467196451
  NPD (past) Authorized official
• Refine PT and Performance - Foley LLC

  • Physical Therapist
  • Foley, AL
  • NPI 1598581225
  NPD (past) Authorized official
• Refine PT and Performance - North Alabama LLC

  • Physical Therapist
  • Decatur, AL
  • NPI 1689346405
  NPD (past) Authorized official

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1225568611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S FLORIDA ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366061927",
            "telephone_number": "251-501-2700",
            "fax_number": "251-501-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S FLORIDA ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366061927",
            "telephone_number": "251-501-2700",
            "fax_number": "251-501-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KYLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH9337",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle@refineptp.com",
            "affiliation": "N",
            "endpointDescription": "Direct Provider Email Account",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "108 S Florida St",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366061927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Mobile, AL
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.