Individual provider Active NPI

Kirby Millanes

  • Physical Therapy Assistant
  • Glendale, CA
National Provider Identifier
1952790263
Registry record updated Jan 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
10200 Issued in CA
Practice address
1253 Alameda Ave
Glendale, CA 91201-1323
Phone
(818) 573-5337
NPI assigned
Jan 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 10200 CA Primary

Addresses

Primary practice location

1253 Alameda Ave
Glendale, CA 91201-1323

Mailing address

1253 Alameda Ave
Glendale, CA 91201-1323

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1420848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420848000000",
    "number": "1952790263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 ALAMEDA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 ALAMEDA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011323",
            "telephone_number": "818-573-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLANES",
        "first_name": "KIRBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-10",
        "last_updated": "2015-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.