NPIMap

Organization Active NPI

Refine PT and Performance - North Alabama LLC

  • Physical Therapist
  • Decatur, AL
National Provider Identifier
1689346405
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REFINE PT AND PERFORMANCE - NORTH ALABAMA LLC
Practice address
1111 Knight St SE
Decatur, AL 35601-6501
Phone
(256) 973-1552
Fax
(256) 973-1553
NPI assigned
Sep 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Kyle ThibodeauxNPI 1225568611
Title
Owner
Phone
(256) 227-9464

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1111 Knight St SE
Decatur, AL 35601-6501

Mailing address

1111 Knight St SE
Decatur, AL 35601-6501
Phone (256) 973-1552

Other practice location 1

3050 Leeman Ferry Rd SW
Huntsville, AL 35801-5613
Phone (256) 973-1552

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220112002761 AL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7810387909 Receives reassigned benefits from 3 practitioners
Practice locations: Decatur, AL; Huntsville, AL

National Provider Directory

National Provider Directory

Locations

1111 Knight St SE
Decatur, AL 35601
Phone (256) 973-1552

3050 Leeman Ferry Rd SW
Huntsville, AL 35801
Phone (256) 973-1552

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1689346405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 KNIGHT ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016501",
            "telephone_number": "256-973-1552",
            "fax_number": "256-973-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 KNIGHT ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016501",
            "telephone_number": "256-973-1552",
            "fax_number": "256-973-1553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3050 Leeman Ferry Rd SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015613",
            "country_code": "US",
            "telephone_number": "256-973-1552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REFINE PT AND PERFORMANCE - NORTH ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-227-9464"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.