Individual provider Active NPI

Mikaela Kristen Roe

  • Physical Therapy Assistant
  • Kansas City, MO
National Provider Identifier
1184955650
Registry record updated Jan 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2009034198 Issued in MO
Practice address
9151 NE 81St Ter
Kansas City, MO 64158-1294
Phone
(816) 415-4971
Fax
(816) 415-8270
NPI assigned
Jan 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2009034198 MO Primary

Addresses

Primary practice location

9151 NE 81St Ter
Kansas City, MO 64158-1294

Mailing address

9151 NE 81St Ter
Kansas City, MO 64158-1294
Phone (816) 415-4971

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
2009034198MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1264204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264204800000",
    "number": "1184955650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9151 NE 81ST TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581294",
            "telephone_number": "816-415-4971",
            "fax_number": "816-415-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9151 NE 81ST TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581294",
            "telephone_number": "816-415-4971",
            "fax_number": "816-415-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "MIKAELA",
        "middle_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-23",
        "last_updated": "2010-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2009034198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2010; 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.