Individual provider Active NPI

Kirk Holle, PT

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1477685808
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006198 Issued in WA
Practice address
907 S Auburn St
Kennewick, WA 99336-5662
Phone
(509) 582-0429
Fax
(509) 582-1182
NPI assigned
Mar 12, 2007
Last updated
Oct 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00006198 WA Primary

Addresses

Primary practice location

907 S Auburn St
Kennewick, WA 99336-5662

Mailing address

824 W Lewis St Ste 204
Pasco, WA 99301-5561
Phone (509) 544-0265

Other identifiers 2

IdentifierTypeStateIssuer
0101550OtherWALABOR AND INDUSTRIES
8334963MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000713 WA Practitioner - Physical Therapist in Private Practice 2163325028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Physical Therapy Inc PSGroup PAC ID 6305747643, 44 clinicians

Practice addresses (Care Compare)

343 Wellsian Way
Richland, WA 99352-4107
Phone (509) 946-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Physical Therapy Inc PS Physical Therapist CurrentSince Jan 1, 2000 Accepting new patients

Locations

35 S Louisiana St
Ste A140
Kennewick, WA 99336
Phone (509) 582-0429

7201 W Clearwater Ave
Ste B101
Kennewick, WA 99336
Phone (509) 544-0265

907 S Auburn St
Kennewick, WA 99336
Phone (509) 582-0429

343 Wellsian Way
Richland, WA 99352
Phone (509) 547-3673

Organizations & group practices 1

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1477685808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 W LEWIS ST STE 204",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015561",
            "telephone_number": "509-544-0265",
            "fax_number": "509-544-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 S AUBURN ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365662",
            "telephone_number": "509-582-0429",
            "fax_number": "509-582-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLE",
        "first_name": "KIRK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0101550",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8334963",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.