Richard J McKibben, PT, DSC, ECS

Primary specialty

Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X

License

PT004832 Issued in GA

Practice address

100 A Lindsey Lane
Kingsland, GA 31548-0000

Phone

(912) 729-1333

Fax

(912) 729-5259

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, PA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Orthopedic Physical Therapy, Inc.Group PAC ID 2264660729, 5 clinicians

Macon Orthopaedic and Hand Center, PAGroup PAC ID 7911994835, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: richard.mckibben.1@16403.direct.athenahealth.com

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.

• Macon Orthopaedic & Hand Center, PA

  dba OrthoGeorgia

  • Orthopaedic Surgery Physician
  • Macon, GA
  • NPI 1356489850

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Physical Therapy Pros, LLC

  • Clinical Electrophysiology Physical Therapist
  • Savannah, GA
  • NPI 1609207885
  Medicare reassignment NPD Authorized official
• Metro Orthopedic Physical Therapy, Inc.

  dba Robert Baker EMG and Nerve Conduction Services

  • Clinical Electrophysiology Physical Therapist
  • Bradford, PA
  • NPI 1255350286
  Medicare reassignment Care Compare group NPD
• Griffin Imaging, LLC

  • Radiology Clinic/Center
  • Griffin, GA
  • NPI 1700199940
  Medicare reassignment NPD
• Optim Orthopedics, LLC

  dba Optim Orthopedics

  • Orthopaedic Surgery Physician
  • Savannah, GA
  • NPI 1780077982
  Medicare reassignment NPD
• Southwest Georgia Rehab, Inc

  • Physical Therapist
  • Cordele, GA
  • NPI 1902120587
  Medicare reassignment NPD
• Columbus Diagnostic Center Inc

  • Diagnostic Radiology Physician
  • Columbus, GA
  • NPI 1316108624
  Medicare reassignment
• Griffin Imaging, LLC

  dba Griffin Open MRI

  • Radiology Clinic/Center
  • Griffin, GA
  • NPI 1154884674
  NPD
• Macon Orthopaedic & Hand Center, PA

  • Orthopaedic Surgery Physician
  • Locust Grove, GA
  • NPI 1760363386
  NPD
• Optim Orthopedics, LLC

  dba Optim Orthopedics

  • Orthopaedic Surgery Physician
  • Jesup, GA
  • NPI 1467845404
  NPD
• Regional Open MRI, LLC

  • Radiology Clinic/Center
  • Thomson, GA
  • NPI 1528128790
  NPD
• Advance Rehabilitation & Consulting Limited Partnership

  • Physical Therapist
  • Saint Marys, GA
  • NPI 1235434283
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1407949134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "706-236-2774",
            "fax_number": "706-802-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 A LINDSEY LANE",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315480000",
            "telephone_number": "912-729-1333",
            "fax_number": "912-729-5259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Johnny Mercer Blvd Ste 10A",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314102169",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 Pine St Ste 880",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312017525",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6330 Primrose Hill Ct Ste 201",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300924544",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Hillcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310214208",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "371 Noah Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "GA",
            "postal_code": "301438708",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "165 N Park Trl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302816509",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4216 Washington Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308094717",
            "country_code": "US",
            "telephone_number": "470-809-1581",
            "fax_number": "470-809-1582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKIBBEN",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "PT, DSC, ECS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "PA",
            "license": "PT032925",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "GA",
            "license": "PT004832",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT004832",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "818354932J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenita Lyons
• Ruxandra Marina Denis Mares, MD
• Marvin P. Jones MD PC
• Genevieve Matherne, OT
• Miney Mathews, MD
• McKinney Medical Center Inc (McKinney Community Health Center)
• Keli L McMullen, SLP
• Andrea Dee McNutt
• Ciara Meadows, CCC-SLP
• Deborah Melton, RN

• Physical Therapist in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.