Nicole Kidd, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

L929736 Issued in MI

Practice address

2265 Livernois
Suite 700
Troy, MI 48083-1639

Phone

(248) 269-0230

Fax

(248) 269-0231

NPI assigned

Sep 11, 2006

Last updated

Sep 7, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Institute for Human Performance IncGroup PAC ID 3779534169, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Michigan Institute for Human Performance Inc

  • Physical Therapist
  • Troy, MI
  • NPI 1023115201
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1730283722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 LIVERNOIS",
            "address_2": "SUITE 700",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831639",
            "telephone_number": "248-269-0230",
            "fax_number": "248-269-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 LIVERNOIS",
            "address_2": "SUITE 700",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831639",
            "telephone_number": "248-269-0230",
            "fax_number": "248-269-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "L929736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "650F396820",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shefali Khullar
• Subhash C Khullar, MD
• Christopher Khuong, LLP
• Eshaal Khurram
• Darren Kibbey, COTA
• Jeffrey Kidder
• Kidology Pediatrics PLLC
• Philip O Kilanowski-Doroh, MD
• Alicia Michelle Kilbourn, MA, LPC, NCC
• Raquel E Killop, CRNA

• Physical Therapist in Troy, MI
• Providers in Troy, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.