Active NPI
Kenneth Welker, PTA
- Physical Therapy Assistant
- Saint Louis, MO
National Provider Identifier
1215209176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2010031415
- Practice address
- 6915 Foxcroft Dr
Saint Louis, MO 63123-1637 - Phone
- (314) 443-9894
- NPI assigned
- Feb 7, 2012
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 2010031415 | MO | Primary |
Addresses
Primary practice location
6915 Foxcroft Dr
Saint Louis, MO 63123-1637
Mailing address
6915 Foxcroft Dr
Saint Louis, MO 63123-1637
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2010031415 | Other | MO | STATE OF MISSOURI, MISSOURI BOARD OF HEALING ARTS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2010031415 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328572800000",
"number": "1215209176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6915 FOXCROFT DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631231637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6915 FOXCROFT DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631231637",
"telephone_number": "314-443-9894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELKER",
"first_name": "KENNETH",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-07",
"last_updated": "2012-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2010031415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MISSOURI, MISSOURI BOARD OF HEALING ARTS",
"identifier": "2010031415",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}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 Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.