Individual provider Active NPI

Mackenzie Thimesch, DPT

  • Physical Therapist
  • Derby, KS
National Provider Identifier
1710727656
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
608 N Mulberry Rd
Derby, KS 67037-3532
Phone
(316) 202-0996
NPI assigned
May 29, 2024
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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 NU Primary

Addresses

Primary practice location

608 N Mulberry Rd
Derby, KS 67037-3532

Mailing address

2615 S Brookmeadow Dr
Garden Plain, KS 67050-8909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250606000128 KS Practitioner - Physical Therapist in Private Practice 1153831433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced PT LLCGroup PAC ID 3678524709, 84 clinicians

Practice addresses (Care Compare)

608 N Mulberry Rd
Advanced PT Derby
Derby, KS 67037-3532
Phone (316) 202-0996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced PT LLC Physical Therapist CurrentSince May 29, 2025 Accepting new patients
Advanced PT LLC Physical Therapist Current Accepting new patients
Advanced PT, LLC Physical Therapist CurrentSince May 29, 2025 Accepting new patients

Locations

608 N Mulberry Rd
Derby, KS 67037
Phone (316) 202-0996

3730 N Ridge Rd
Ste 500
Wichita, KS 67205
Phone (316) 440-4901

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

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": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1710727656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 S BROOKMEADOW DR",
            "city": "GARDEN PLAIN",
            "state": "KS",
            "postal_code": "670508909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 N MULBERRY RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373532",
            "telephone_number": "316-202-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIMESCH",
        "first_name": "MACKENZIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.