Individual provider Active NPI

Kimberly Diane Levenhagen, DPT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1164553335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1887 Issued in MO
Practice address
3437 Caroline St
Room 1026
Saint Louis, MO 63104-1111
Phone
(314) 977-8548
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1887 MO Primary

Addresses

Primary practice location

3437 Caroline St
Room 1026
Saint Louis, MO 63104-1111

Mailing address

506 Webster Path CT
Saint Louis, MO 63119-3941
Phone (314) 963-1171

Other names 1

  • Prof. Kimberly Moore Levenhagen Professional name

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

LicenseStateTypeSpecialty
1887MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164553335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 WEBSTER PATH CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631193941",
            "telephone_number": "314-963-1171",
            "fax_number": "314-968-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 CAROLINE ST",
            "address_2": "ROOM 1026",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041111",
            "telephone_number": "314-977-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENHAGEN",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "1887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LEVENHAGEN",
            "middle_name": "MOORE",
            "prefix": "PROF.",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.