Active NPI
Kevin D Barclay, PT
- Physical Therapist
- Jackson, MI
National Provider Identifier
1376664771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501004320
- Practice address
- 2136 Robinson Rd
Suite 1
Jackson, MI 49203-3557 - Phone
- (517) 750-2540
- Fax
- (517) 750-2044
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501004320 | MI | Primary |
Addresses
Primary practice location
2136 Robinson Rd
Suite 1
Jackson, MI 49203-3557
Mailing address
3073 Shirley Dr
Jackson, MI 49201-7010
Phone (517) 990-6211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0C80788 | Other | MI | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501004320 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739145600000",
"number": "1376664771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3073 SHIRLEY DR",
"city": "JACKSON",
"state": "MI",
"postal_code": "492017010",
"telephone_number": "517-990-6211",
"fax_number": "517-990-6212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2136 ROBINSON RD",
"address_2": "SUITE 1",
"city": "JACKSON",
"state": "MI",
"postal_code": "492033557",
"telephone_number": "517-750-2540",
"fax_number": "517-750-2044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARCLAY",
"first_name": "KEVIN",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2025-02-10",
"certification_date": "2025-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501004320",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0C80788",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.