Individual provider Active NPI

Michael R Gurk, PT

  • Physical Therapist
  • Kihei, HI
National Provider Identifier
1629136916
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4098 Issued in HI
Practice address
1325 S Kihei Road
Suite 110
Kihei, HI 96753-8145
Phone
(808) 874-6972
Fax
(808) 874-6973
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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 PT11617 CA
Physical Therapist 225100000X PT4098 HI Primary

Addresses

Primary practice location

1325 S Kihei Road
Suite 110
Kihei, HI 96753-8145

Mailing address

1325 S Kihei Road
Suite 110
Kihei, HI 96753-8145
Phone (808) 874-6972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11617CAMDAddiction (Substance Use Disorder) Counselor
PT4098HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob a Spencer DO Inc Past Accepting new patients
Adorador Enterprises Inc PastSince Dec 1, 2017 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1629136916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S KIHEI ROAD",
            "address_2": "SUITE 110",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538145",
            "telephone_number": "808-874-6972",
            "fax_number": "808-874-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S KIHEI ROAD",
            "address_2": "SUITE 110",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538145",
            "telephone_number": "808-874-6972",
            "fax_number": "808-874-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURK",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11617",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT4098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.