Individual provider Active NPI

Evan Brock Kirby

  • Physical Therapist
  • Northport, AL
National Provider Identifier
1568941920
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
92 McFarland Blvd
Northport, AL 35476-3348
Phone
(205) 344-9161
NPI assigned
Aug 7, 2018
Last updated
Aug 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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 AL Primary

Addresses

Primary practice location

92 McFarland Blvd
Northport, AL 35476-3348

Mailing address

251 Johnston St SE Ste 200
Decatur, AL 35601-2515
Phone (256) 350-1764

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024002517 AL Practitioner - Physical Therapist in Private Practice 1052664851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of South Alabama College of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
DCH Encore Rehabilitation, LLCGroup PAC ID 1759621295, 10 clinicians

Practice addresses (Care Compare)

92 McFarland Blvd
Northport, AL 35476-3348
Phone (205) 344-9161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc Physical Therapist CurrentSince Aug 1, 2018 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Aug 1, 2018 Accepting new patients
DCH Encore Rehabilitation, LLC Physical Therapist CurrentSince Jan 14, 2019 Accepting new patients

Locations

251 Johnston St SE
Ste 200
Decatur, AL 35601

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

100 W Lake Professional Park
Ste 1
Geneva, AL 36340
Phone (334) 684-8905

92 McFarland Blvd
Northport, AL 35476
Phone (205) 344-9161

1050 Ruby Tyler Pkwy
Tuscaloosa, AL 35404
Phone (205) 750-5394

6561 Highway 69 S
#A
Tuscaloosa, AL 35405
Phone (205) 722-1032

Organizations & group practices 3

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1568941920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 200",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-350-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MCFARLAND BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763348",
            "telephone_number": "205-344-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "EVAN",
        "middle_name": "BROCK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.