Individual provider Active NPI

Chad E Helmer, PT

  • Physical Therapist
  • Liberty, MO
National Provider Identifier
1073565149
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
112594 Issued in MO
Practice address
1512 NE 96TH St
Ste a
Liberty, MO 64068-7174
Phone
(816) 792-0775
Fax
(816) 792-0776
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 6

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.

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
112594MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Serc of Kearney Inc Physical Therapist PastSince Feb 1, 2006 Accepting new patients
Spine and Extremity Rehabilitation Center of Raytown Inc Physical Therapist Past Accepting new patients
Mid America Balance Institute of Clay Platte County Missouri Past Accepting new patients
Serc of Liberty LLC Physical Therapist PastSince Dec 12, 2005 Accepting new patients
Mid America Balance Institute of Cass County Missouri Past Accepting new patients
Serc Hand North Inc PastSince Apr 30, 2003 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 112594 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

1512 NE 96TH St
Ste a
Liberty, MO 64068-7174

Mailing address

17134 Bel Ray PL
Belton, MO 64012-5331
Phone (816) 226-4011

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
MA4370012OtherMOMEDICARE PTAN
26735101OtherBCBS KC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 21, 2014.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1073565149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17134 BEL RAY PL",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "640125331",
            "telephone_number": "816-226-4011",
            "fax_number": "816-524-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 NE 96TH ST",
            "address_2": "STE A",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640687174",
            "telephone_number": "816-792-0775",
            "fax_number": "816-792-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMER",
        "first_name": "CHAD",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "112594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA4370012",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "26735101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.