Individual provider Active NPI

Laurel Ann Kuebler, PT

  • Physical Therapist
  • Grand Island, NE
National Provider Identifier
1356491062
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3486 Issued in NE
Practice address
620 N Diers Ave
Suite 300
Grand Island, NE 68803-4984
Phone
(308) 382-0344
Fax
(308) 382-3241
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05007727A IN
Physical Therapist 225100000X 3486 NE Primary

Addresses

Primary practice location

620 N Diers Ave
Suite 300
Grand Island, NE 68803-4984

Mailing address

PO Box 5285
Grand Island, NE 68802-5285
Phone (308) 382-0344

Other names 1

  • Laurel Ann McKinny Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150914002166 NE Practitioner - Physical Therapist in Private Practice 5496828436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Go Physical Therapy LLCGroup PAC ID 0749258994, 98 clinicians

Practice addresses (Care Compare)

905 N Custer Ave
Grand Island, NE 68803-4304
Phone (308) 398-2170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3486NEMDCounselor
05007727AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Rehab, Inc. Physical Therapist Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1356491062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5285",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025285",
            "telephone_number": "308-382-0344",
            "fax_number": "308-382-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N DIERS AVE",
            "address_2": "SUITE 300",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034984",
            "telephone_number": "308-382-0344",
            "fax_number": "308-382-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEBLER",
        "first_name": "LAUREL",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007727A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "MCKINNY",
            "middle_name": "ANN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.