Individual provider Active NPI

Kimberly Ann Moler, DPT

  • Physical Therapist
  • Saint Peters, MO
National Provider Identifier
1184162067
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2017003429 Issued in MO
Practice address
4887 Mexico Rd
Saint Peters, MO 63376-2577
Phone
(636) 928-1036
NPI assigned
Feb 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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 2017003429 MO Primary

Addresses

Primary practice location

4887 Mexico Rd
Saint Peters, MO 63376-2577

Mailing address

4887 Mexico Rd
Saint Peters, MO 63376-2577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414000747 MO Practitioner - Physical Therapist in Private Practice 9234525536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1051 Kent St
Liberty, MO 64068-2257
Phone (816) 370-5242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017003429MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince Apr 12, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Apr 12, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Apr 12, 2022 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince Apr 12, 2022 Accepting new patients
SSM Select Rehab St. Louis, LLC Past Accepting new patients
SSM Select Rehab St Louis LLC Past Accepting new patients

Locations

16255 Chesterfield Pkwy W
Chesterfield, MO 63017
Phone (636) 812-6942

3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767

1800 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 255-8094

2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1184162067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 MEXICO RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887 MEXICO RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762577",
            "telephone_number": "636-928-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2017003429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.