Individual provider Active NPI

Kent Willburn, PT

  • Physical Therapist
  • Grand Island, NE
National Provider Identifier
1700848603
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1348 Issued in NE
Practice address
3004 W Faidley Ave
Grand Island, NE 68803-4109
Phone
(308) 382-0344
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1348 NE Primary

Addresses

Primary practice location

3004 W Faidley Ave
Grand Island, NE 68803-4109

Mailing address

3004 W Faidley Ave
Grand Island, NE 68803-4109
Phone (308) 382-0344

Other names 1

  • Kent Willburn Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120501000844 NE Practitioner - Physical Therapist in Private Practice 3476715806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Go Physical Therapy LLCGroup PAC ID 0749258994, 98 clinicians

Practice addresses (Care Compare)

1115 M St
Aurora, NE 68818-2019
Phone (402) 694-5170

Merit-based Incentive Payment System (MIPS)

Final score
85.76 of 100Reported as group
Quality
89.57
Improvement activities
40
Cost
71.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Go Physical Therapy, LLC Physical Therapist CurrentSince Jan 1, 2012 Accepting new patients

Locations

1115 M St
Aurora, NE 68818
Phone (402) 694-5170

620 N Diers Ave
Ste 300
Grand Island, NE 68803
Phone (308) 382-0344

3004 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-0344

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700848603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034109",
            "telephone_number": "308-382-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034109",
            "telephone_number": "308-382-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLBURN",
        "first_name": "KENT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENT",
            "last_name": "WILLBURN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.