Kimberly Anne Tyborowski, PT, DPT, ATC, CIDN

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305207469 Issued in VA

Practice address

17453 Jefferson Davis Hwy.
Dumfries, VA 22026

Phone

(703) 221-3913

Fax

(703) 221-3203

NPI assigned

Nov 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Kimberly Anne Stoner Former name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fusion Physiotherapy Associates LLCGroup PAC ID 5092093575, 19 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.

• Fusion Physiotherapy Associates LLC

  • Physical Therapist
  • Fredericksburg, VA
  • NPI 1730530213

  DC

  Medicare reassignment Care Compare group NPD
• Physicial Therapy Associates of King George

  • Physical Therapist
  • King George, VA
  • NPI 1396821120
  NPD (past)

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1356770945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17453 JEFFERSON DAVIS HWY.",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22026",
            "telephone_number": "703-221-3913",
            "fax_number": "703-221-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17453 JEFFERSON DAVIS HWY.",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22026",
            "telephone_number": "703-221-3913",
            "fax_number": "703-221-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYBOROWSKI",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC, CIDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "2000001777",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "STONER",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "PT, DPT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Dumfries, VA
• Providers in Dumfries, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.