NPIMap

Organization Active NPI

Kingsley Physical Therapy, P.L.L.C.

Doing business as Kingsley Physical Therapy

  • Physical Therapy Clinic/Center
  • Kingsley, MI
National Provider Identifier
1871549857
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
5501010646 Issued in MI
Legal business name
KINGSLEY PHYSICAL THERAPY, P.L.L.C.
Doing business as
Kingsley Physical Therapy
Practice address
409 W Main St
Kingsley, MI 49649-9481
Phone
(231) 263-1001
Fax
(231) 263-1002
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Lars Mitchell, MPT, OCS, CSCSNPI 1629035050
Title
Owner/Physical Therapist
Phone
(231) 263-1001

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 Therapy Clinic/Center 261QP2000X 5501010646 MI Primary

Addresses

Primary practice location

409 W Main St
Kingsley, MI 49649-9481

Mailing address

409 W Main St
Kingsley, MI 49649-9481
Phone (231) 263-1001

Other names 1

  • Kingsley Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060530000021 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2264443530 Receives reassigned benefits from 5 practitioners
Practice locations: Kingsley, MI

National Provider Directory

National Provider Directory

Locations

409 W Main St
Kingsley, MI 49649
Phone (231) 263-1001

Practitioners & affiliated clinicians

Practitioners 7

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": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1871549857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W MAIN ST",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499481",
            "telephone_number": "231-263-1001",
            "fax_number": "231-263-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W MAIN ST",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499481",
            "telephone_number": "231-263-1001",
            "fax_number": "231-263-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSLEY PHYSICAL THERAPY, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LARS",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "231-263-1001",
        "authorized_official_credential": "MPT, OCS, CSCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501010646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingsley Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingsley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.