Individual provider Active NPI

Kimberly Brook Morales, PT, DPT

  • Physical Therapist
  • Yuma, AZ
National Provider Identifier
1407060544
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5546 Issued in AZ
Practice address
1021 W 23Rd St
Yuma, AZ 85364-8347
Phone
(928) 782-5260
Fax
(928) 783-0383
NPI assigned
May 9, 2007
Last updated
Nov 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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 1682 NV
Physical Therapist 225100000X 5546 AZ Primary

Addresses

Primary practice location

1021 W 23Rd St
Yuma, AZ 85364-8347

Mailing address

PO Box 5553
Yuma, AZ 85366-2477
Phone (928) 782-5260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190610000813 FL Practitioner - Physical Therapist in Private Practice 6103050612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Ridge Medical Centers IncGroup PAC ID 2365608452, 3 clinicians

Practice addresses (Care Compare)

115 Lake Davenport Blvd
Davenport, FL 33897-9440
Phone (863) 256-5030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5546AZMDPhysical Therapist
1682NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Ridge Medical Centers, Inc CurrentSince May 1, 2019 Accepting new patients
Four Corners Chiropractic Centers PA Past Accepting new patients

Locations

109 Lake Davenport Blvd
Davenport, FL 33897
Phone (856) 256-5030

115 Lake Davenport Blvd
Davenport, FL 33897
Phone (863) 256-5030

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1407060544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5553",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853662477",
            "telephone_number": "928-782-5260",
            "fax_number": "928-782-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W 23RD ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648347",
            "telephone_number": "928-782-5260",
            "fax_number": "928-783-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "KIMBERLY",
        "middle_name": "BROOK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1682",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.