Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Kicker

Individual provider Physical Therapist · NPI 1124610837

Ethan Kicker is a Physical Therapist in Private Practice in Pelham, Alabama. Qualified in 2020, 6 years ago. Practices with Therapy South - Alabaster, a 3-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
6
Licensed in
AL
In the registry since
2021
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Practice location Address checks out

3569 Pelham Pkwy Ste 7
Pelham, AL 35124-2033
Phone: (205) 664-8404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PTH10221 (AL)

Record details

NPI number1124610837
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 4, 2021
Last updated in NPPESFebruary 4, 2021
Certification dateFebruary 4, 2021
Mailing address2823 Greystone Commercial Blvd, Hoover, AL 35242-2660

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Therapy South - Alabaster — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Pelham