Individual provider Active NPI

Thomas William Kirkby, DPT

  • Physical Therapist
  • Petoskey, MI
National Provider Identifier
1942464870
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013904 Issued in MI
Practice address
2609 Charlevoix Ave
Petoskey, MI 49770-8524
Phone
(989) 858-5107
NPI assigned
Jul 10, 2008
Reactivated
Mar 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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 5501013904 MI Primary

Addresses

Primary practice location

2609 Charlevoix Ave
Petoskey, MI 49770-8524

Mailing address

2609 Charlevoix Ave
Petoskey, MI 49770-8336
Phone (989) 858-5107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080919000518 MI Practitioner - Physical Therapist in Private Practice 6103993902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2609 Charlevoix Rd
Unit 3
Petoskey, MI 49770-8524
Phone (231) 439-3750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501013904MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PGPT, LLC Physical Therapist CurrentSince Jun 12, 2024 Accepting new patients
First Choice Physical Therapy, Inc CurrentSince Jun 9, 2024 Accepting new patients

Locations

2609 Charlevoix Rd
Petoskey, MI 49770
Phone (231) 439-3750

2609 Charlevoix Rd
Unit 3
Petoskey, MI 49770

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1942464870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 CHARLEVOIX AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708336",
            "telephone_number": "989-858-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 CHARLEVOIX AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708524",
            "telephone_number": "989-858-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKBY",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "deactivation_date": "2018-02-27",
        "reactivation_date": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; 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.