Active NPI
Ammon Benjamin Birk, DPT
- Physical Therapist
- Kimberly, ID
National Provider Identifier
1851889182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-4245
- Practice address
- 940 Ballard Way
Kimberly, ID 83341 - Phone
- (801) 874-0479
- NPI assigned
- Apr 23, 2018
- Last updated
- Jun 23, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-4245 | ID | Primary |
Addresses
Primary practice location
940 Ballard Way
Kimberly, ID 83341
Mailing address
940 Ballard Way
Kimberly, ID 83341-5162
Phone (801) 874-0479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-4245 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529712000000",
"number": "1851889182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 BALLARD WAY",
"city": "KIMBERLY",
"state": "ID",
"postal_code": "833415162",
"telephone_number": "801-874-0479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BALLARD WAY",
"city": "KIMBERLY",
"state": "ID",
"postal_code": "83341",
"telephone_number": "801-874-0479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRK",
"first_name": "AMMON",
"middle_name": "BENJAMIN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-23",
"last_updated": "2018-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-4245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kimberly, ID
- Dallin Atkinson, PHARMD
- Aurora Springs Counseling
- Trevor John Baker, PT, DPT, GCS
- Leslie Marie Bell, RD
- Brooke Bertrand, MS
- Danton Lafey Bradshaw, D.D.S.
- Bumble Bee Pediatric Therapy
- Elsa Carrow, M.A. EDUCATION
- Charolais Care II, Inc (Valley South Hospital for Geriatric Psychiatry)
- Charolais Care II, Inc (Oak Creek Rehabilitation Center of Kimberly)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.