Kimberly Michelle Durie

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

319 S Bridge St
Linden, MI 48451-8966

Phone

(810) 735-0010

NPI assigned

Sep 3, 2019

Last updated

Nov 29, 2019By 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 names 1

• Kimberly Michelle Fagan Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1750939609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S BRIDGE ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518966",
            "telephone_number": "810-735-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURIE",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "FAGAN",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Dangelo Attard
• Haley Daniels
• Dignity Hospic
• Kirsten Donnellon, O.D.
• Megan N Dubois
• Taylor Lynn Eastman, LMSW
• William Edgar, MD
• Hannah Elliott, LCSW
• Charlotte Teresa Ferrington, PTA
• William Cleland Forbes, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.