Organization Active NPI

K 13 Physical Therapy & Sports Medicine PC

  • Physical Therapist
  • Saint Johns, MI
National Provider Identifier
1861405581
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
K 13 PHYSICAL THERAPY & SPORTS MEDICINE PC
Practice address
1507 Waterford Pkwy
Saint Johns, MI 48879-9630
Phone
(989) 227-5404
Fax
(989) 227-5415
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Barbara A Koenigsknecht, PTNPI 1205849940
Title
President
Phone
(989) 227-5404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1507 Waterford Pkwy
Saint Johns, MI 48879-9630

Mailing address

PO Box 10
Mason, MI 48854-0010
Phone (517) 676-9788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050125000201 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406806876 Receives reassigned benefits from 6 practitioners
Practice locations: Laingsburg, MI; Portland, MI; Saint Johns, MI

National Provider Directory

National Provider Directory

Locations

239 E Grand River Rd
Laingsburg, MI 48848
Phone (517) 651-1322

1240 E Grand River Ave
Portland, MI 48875
Phone (517) 743-6122

1507 Waterford Pkwy
Ste A
Saint Johns, MI 48879
Phone (989) 227-5404

1507 Waterford Pkwy
Saint Johns, MI 48879
Phone (989) 227-5404

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861405581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010",
            "telephone_number": "517-676-9788",
            "fax_number": "517-676-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 WATERFORD PKWY",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799630",
            "telephone_number": "989-227-5404",
            "fax_number": "989-227-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K 13 PHYSICAL THERAPY & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOENIGSKNECHT",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-227-5404",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.