Active NPI
Michelle Gronemeyer
- Physical Therapist
- Kirksville, MO
National Provider Identifier
1114396900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2015024017
- Practice address
- 316 S Osteopathy Ave
Kirksville, MO 63501-1446 - Phone
- (660) 665-2887
- NPI assigned
- Sep 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2015024017 | MO | Primary |
Addresses
Primary practice location
316 S Osteopathy Ave
Kirksville, MO 63501-1446
Mailing address
316 S Osteopathy Ave
Kirksville, MO 63501-1446
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015024017 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1114396900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 S OSTEOPATHY AVE",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635011446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 S OSTEOPATHY AVE",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635011446",
"telephone_number": "660-665-2887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRONEMEYER",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-22",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2015024017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.