Individual provider Active NPI

Kade McJunkin, DPT

  • Physical Therapist
  • Rock Springs, WY
National Provider Identifier
1740928050
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2169 Issued in WY
Practice address
1977 Dewar Dr Ste J
Rock Springs, WY 82901-5757
Phone
(307) 382-3228
Fax
(307) 382-6886
NPI assigned
May 25, 2022
Last updated
May 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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 2169 WY Primary

Addresses

Primary practice location

1977 Dewar Dr Ste J
Rock Springs, WY 82901-5757

Mailing address

1977 Dewar Dr Ste J
Rock Springs, WY 82901-5757
Phone (307) 382-3228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220901000808 WY Practitioner - Physical Therapist in Private Practice 5890179378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physical Therapy, LLCGroup PAC ID 6901906452, 16 clinicians

Practice addresses (Care Compare)

1977 Dewar Dr
Suite J
Rock Springs, WY 82901-5757
Phone (307) 382-3228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2169WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy, LLC Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients

Locations

2100 W Teton Blvd
Green River, WY 82935
Phone (307) 875-1788

1977 Dewar Dr
Ste J
Rock Springs, WY 82901
Phone (307) 382-3228

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, 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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1740928050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1977 DEWAR DR STE J",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015757",
            "telephone_number": "307-382-3228",
            "fax_number": "307-382-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 DEWAR DR STE J",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015757",
            "telephone_number": "307-382-3228",
            "fax_number": "307-382-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCJUNKIN",
        "first_name": "KADE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "2169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.