| Richard J Mckibben, PT, DWC, ECS | |
|
100 A Lindsey Lane, Kingsland, GA 31548-0000 | |
| (912) 729-1333 | |
| (912) 729-5259 |
| Full Name | Richard J Mckibben |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 31 Years |
| Location | 100 A Lindsey Lane, Kingsland, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407949134 | NPI | - | NPPES |
| 818354932J | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT004832 (Georgia) | Primary |
| 2251E1300X | Physical Therapist - Electrophysiology, Clinical | PT004832 (Georgia) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Macon Orthopaedic And Hand Center, Pa | 7911994835 | 86 |
| Griffin Imaging, Llc | 9436054129 | 13 |
| Provider Name | Columbus Diagnostic Center Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1316108624 PECOS PAC ID: 3375455884 Enrollment ID: O20040429001218 |
| Provider Name | Macon Orthopaedic & Hand Center, Pa |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1356489850 PECOS PAC ID: 7911994835 Enrollment ID: O20040430000378 |
| Provider Name | Southwest Georgia Rehab Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1902120587 PECOS PAC ID: 6204966740 Enrollment ID: O20100610000420 |
| Provider Name | Griffin Imaging, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1700199940 PECOS PAC ID: 9436054129 Enrollment ID: O20101117000015 |
| Provider Name | Physical Therapy Pros, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1609207885 PECOS PAC ID: 1254569262 Enrollment ID: O20140121002013 |
| Provider Name | Optim Orthopedics Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780077982 PECOS PAC ID: 9931427002 Enrollment ID: O20150429001342 |
| Provider Name | Regional Open Mri, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1528128790 PECOS PAC ID: 5092796318 Enrollment ID: O20160411000875 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J Mckibben, PT, DWC, ECS Po Box 949, Rome, GA 30162-0949 Ph: (706) 236-2774 | Richard J Mckibben, PT, DWC, ECS 100 A Lindsey Lane, Kingsland, GA 31548-0000 Ph: (912) 729-1333 |
Mrs. Marisa G Harvey, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1204 Hospitality Ave Ste E, Kingsland, GA 31548 Phone: 912-996-2069 Fax: 912-265-0041 | |
Mrs. Lisa Leanne Gentzler, M.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1319 E King Ave, Kingsland, GA 31548 Phone: 404-351-5307 Fax: 404-351-5308 | |
Allyson M Sunderman, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln # A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 | |
Hunter Beck, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1390 Boone Avenue Ext Ste 23, Kingsland, GA 31548 Phone: 912-319-0400 | |
Robert A Richards, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln, Suite A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 | |
Chad Nolan Oakley, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 100 Lindsey Ln # A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 | |
Michael J Janusko, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln # A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 |