Individual provider Active NPI

Michael Robert Myers, DPT

  • Physical Therapist
  • Fairbanks, AK
National Provider Identifier
1265718548
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2509 Issued in AK
Practice address
158 Frog Pond Cir
Fairbanks, AK 99712-1244
Phone
(907) 251-5472
Fax
(907) 600-1823
NPI assigned
Oct 31, 2011
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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 2509 AK Primary

Addresses

Primary practice location

158 Frog Pond Cir
Fairbanks, AK 99712-1244

Mailing address

158 Frog Pond Cir
Fairbanks, AK 99712-1244
Phone (907) 251-5472

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121221000297 AK Practitioner - Physical Therapist in Private Practice 8325215981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2509AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy Inc Physical Therapist PastSince Jan 1, 2006 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1265718548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 FROG POND CIR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997121244",
            "telephone_number": "907-251-5472",
            "fax_number": "907-600-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 FROG POND CIR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997121244",
            "telephone_number": "907-251-5472",
            "fax_number": "907-600-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.