Chandler R Altom, PT, DPT
Individual provider Active NPI Physical Therapist · Shawnee, KS
NPI 1003486077 · NPPES record last updated Jun 30, 2021
Key facts
- NPI
- 1003486077
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-06809 (KS)
- Practice address
- 11207 Shawnee Mission Pkwy
Shawnee, KS 66203-3333 - Phone
- (913) 275-5751
- Fax
- (913) 320-2217
- NPI assigned
- Jun 30, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Athletico LTD
Practice addresses (Care Compare)
11207 Shawnee Mission Pkwy
Shawnee, KS 66203-3333
Phone (913) 275-5751
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210727001146 | KS | Practitioner - Physical Therapist in Private Practice | 9830592971 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-06809 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current |
Accepting new patients |
| Athletico LTD | Physical Therapist | Current |
Accepting new patients |
| Athletico LTD | Physical Therapist | Past | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
9544 Antioch Rd
Overland Park, KS 66212
Phone (913) 396-6756
Interoperability endpoints
- chandler.altom.p9@direct.athleticoltd.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-06809 | KS | Yes |
Addresses
Primary practice location
11207 Shawnee Mission Pkwy
Shawnee, KS 66203-3333
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980
Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.