Organization Active NPI

Ignite Physical Therapy LLC

Doing business as Ignite Physical Therapy

  • Physical Therapist
  • Lapeer, MI
National Provider Identifier
1467964171
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IGNITE PHYSICAL THERAPY LLC
Doing business as
Ignite Physical Therapy
Practice address
867 S Main St
Lapeer, MI 48446-4177
Phone
(810) 969-4841
Fax
(810) 969-4843
NPI assigned
Nov 3, 2017
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Kevin Richard Eckles, DPTNPI 1992963375
Title
Owner
Phone
(810) 969-4841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

867 S Main St
Lapeer, MI 48446-4177

Mailing address

1191 S Lapeer Rd
Lapeer, MI 48446-3081
Phone (810) 969-4841

Other names 1

  • Ignite Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180618002814 MI Part B Supplier - Clinic/Group Practice 4486909306 Receives reassigned benefits from 2 practitioners
Practice locations: Lapeer, MI

National Provider Directory

National Provider Directory

Locations

1191 S Lapeer Rd
Lapeer, MI 48446
Phone (810) 969-4841

867 S Main St
Lapeer, MI 48446
Phone (810) 969-4841

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1467964171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 S LAPEER RD",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484463081",
            "telephone_number": "810-969-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 S MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464177",
            "telephone_number": "810-969-4841",
            "fax_number": "810-969-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "ECKLES",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-969-4841",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ignite Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.