Gary Dwayne Eichenberger, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2010031806 Issued in MO

Practice address

102 S Forrest Ave
Liberty, MO 64068-1908

Phone

(515) 341-2721

NPI assigned

Mar 30, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complete PT, LLCGroup PAC ID 2062786825, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Complete PT, LLC

  • Physical Therapy Clinic/Center
  • Liberty, MO
  • NPI 1790214252

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Hill Pro-Motion Physical Therapy, LLC

  • Physical Therapist
  • Lees Summit, MO
  • NPI 1538431333
  Medicare reassignment
• Boost Sports Performance, LLC

  • Physical Therapy Clinic/Center
  • Lees Summit, MO
  • NPI 1548428931
  NPD (past)

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1154610186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 W 75TH ST",
            "address_2": "STE. 350",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042205",
            "telephone_number": "913-362-8317",
            "fax_number": "913-362-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S FORREST AVE",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681908",
            "telephone_number": "515-341-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHENBERGER",
        "first_name": "GARY",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2010031806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "12198273",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine D Easley, FNP-C
• Baylie Alexandra Edwards Van Pelt
• Sandra Eggers, FNP-BC
• Suzanne Marie Eggers, M.D.
• Sarah E Ehlers, (LCSW)
• Raonak Ekram, MD
• Elizabeth Elizondo
• Katie Ellermeier
• Madeline Anne Elliott, CCC-SLP
• Tiphanie Embry

• Physical Therapist in Liberty, MO
• Providers in Liberty, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.