Kathleen Herndon, PT
Individual provider Active NPI Physical Therapist · Saint Clair, MO
NPI 1114341997 · NPPES record last updated Mar 18, 2022
Key facts
- NPI
- 1114341997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 100401 (MO)
- Practice address
- 605 N Commercial Ave
Saint Clair, MO 63077-1103 - Phone
- (636) 629-2414
- NPI assigned
- Feb 13, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100401 | MO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 100401 | MO | Yes |
Addresses
Primary practice location
605 N Commercial Ave
Saint Clair, MO 63077-1103
Mailing address
1313 Auburn Hills Dr
Saint Charles, MO 63304-2449
Other providers in Saint Clair, MO
- Hartman Investment Properties Inc
- Karen Ann Hays
- Paige Helmig
- Rebekah Suezann Helmig
- Nancy Herbert
- Martin J Hinterlong
- Mary Lynne Jackson
- Grace Kelley
- Haley Kelly
- Kiko Enterprises, LLC
All providers in Saint Clair, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.