Active NPI
Kathryn Whightsel, PT, DPT, MBA
- Physical Therapist
- Arnold, MO
National Provider Identifier
1124630702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2020025135
- Practice address
- 3488 Jeffco Blvd Ste 102
Arnold, MO 63010-6015 - Phone
- (636) 464-5439
- NPI assigned
- Aug 17, 2020
- 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 | 2020025135 | MO | Primary |
Addresses
Primary practice location
3488 Jeffco Blvd Ste 102
Arnold, MO 63010-6015
Mailing address
1907 Sunset Ave
Effingham, IL 62401-4321
Phone (217) 690-3630
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
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020025135 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1124630702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 SUNSET AVE",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624014321",
"telephone_number": "217-690-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3488 JEFFCO BLVD STE 102",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630106015",
"telephone_number": "636-464-5439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHIGHTSEL",
"first_name": "KATHRYN",
"credential": "PT, DPT, MBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2020025135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.