Individual provider Active NPI

Thomas Ronck, DPT

  • Physical Therapist
  • Lees Summit, MO
National Provider Identifier
1083064638
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2016019572 Issued in MO
Practice address
100 NE Tudor Rd Ste 110
Lees Summit, MO 64086-5601
Phone
(816) 554-6003
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2016019572 MO Primary
Physical Therapist 225100000X 11-05320 KS

Addresses

Primary practice location

100 NE Tudor Rd Ste 110
Lees Summit, MO 64086-5601

Mailing address

100 NE Tudor Rd Ste 110
Lees Summit, MO 64086-5601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803000931 MO Practitioner - Physical Therapist in Private Practice 3072807775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

407 E Russell Ave
BLDG a Suite 6
Warrensburg, MO 64093-1242
Phone (660) 429-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-05320KSMDPhysical Therapist
2016019572MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Physical Rehabilitation and Sports Medicine, LLC Physical Therapist CurrentSince Feb 1, 2017 Accepting new patients
Holista, LLC Past Accepting new patients

Locations

407 E Russell Ave
#A6
Warrensburg, MO 64093
Phone (660) 429-4700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1083064638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE TUDOR RD STE 110",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE TUDOR RD STE 110",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865601",
            "telephone_number": "816-554-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONCK",
        "first_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016019572",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-05320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.