Nicole A Kirkendall, DPT, CERT. MDT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018277 Issued in MI

Practice address

44925 Morley Dr
Clinton TWP, MI 48036-1354

Phone

(586) 846-4320

Fax

(586) 846-4326

NPI assigned

Jul 8, 2009

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

• Nicole A Moundros Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• High Performance Physical Therapy LLC

  • Physical Therapist
  • Gulf Shores, AL
  • NPI 1255158242
  NPD Authorized official
• Physical Therapy Partners Nevada LLC

  • Physical Therapist
  • Reno, NV
  • NPI 1407924178
  NPD (past)

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1366671620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44925 MORLEY DR",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480361354",
            "telephone_number": "586-846-4320",
            "fax_number": "586-846-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44925 MORLEY DR",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480361354",
            "telephone_number": "586-846-4320",
            "fax_number": "586-846-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKENDALL",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "DPT, CERT. MDT, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305207304",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MOUNDROS",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Allen Kincer
• Mark Allen Kincer
• Thomas Fohnatee King, D.O
• Jeffrey M Kirby
• Tracy Kirkconnell
• Adam Laurence Klemz, LLMSW
• Alicia Kochan, LLMSW
• Naomi Koenders Peyerk, CRNA
• Andrea Lynn Koerber, LLMSW
• Lauren Marie Koerber, LLMSW

• Physical Therapist in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.