Individual provider Active NPI

Samuel Kibler

  • Physical Therapist
  • Cresson, PA
National Provider Identifier
1689344335
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
7452 Admiral Peary Hwy Ste 3
Cresson, PA 16630-1706
Phone
(814) 408-2092
NPI assigned
Sep 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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 Primary

Addresses

Primary practice location

7452 Admiral Peary Hwy Ste 3
Cresson, PA 16630-1706

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 541-1974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012000015 PA Practitioner - Physical Therapist in Private Practice 5193123818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7452 Admiral Peary Hwy
Suite 3
Cresson, PA 16630-1706
Phone (814) 408-2092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

7452 Admiral Peary Hwy
Ste 3
Cresson, PA 16630
Phone (814) 408-2092

1225 Scalp Ave
Johnstown, PA 15904
Phone (814) 961-3304

506 Marwalt Ln
Roaring Spring, PA 16673
Phone (814) 224-1370

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1689344335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-541-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7452 ADMIRAL PEARY HWY STE 3",
            "city": "CRESSON",
            "state": "PA",
            "postal_code": "166301706",
            "telephone_number": "814-408-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBLER",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cresson, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.