Individual provider Active NPI

Kennedi McVicker

  • Physical Therapist
  • Warrensburg, MO
National Provider Identifier
1215711536
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022043948 Issued in MO
Practice address
609 E Young Ave Unit B1-2
Warrensburg, MO 64093-9609
Phone
(660) 747-2370
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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 2022043948 MO Primary

Addresses

Primary practice location

609 E Young Ave Unit B1-2
Warrensburg, MO 64093-9609

Mailing address

609 E Young Ave
Warrensburg, MO 64093-9609
Phone (660) 747-2370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318001813 MO Practitioner - Physical Therapist in Private Practice 2961849690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

9101 N Ambassador Dr
Kansas City, MO 64154-7295
Phone (816) 631-0847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022043948MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Mar 11, 2024 Accepting new patients
Onr National Speech Pathology Inc Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients

Locations (25 of 46)

2069 Missouri State Rd
Arnold, MO 63010
Phone (636) 218-2009

4150 W Republic Rd
Brookline, MO 65619
Phone (417) 216-7046

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

16300 Justus Post Rd
Chesterfield, MO 63017
Phone (314) 596-9660

15201 Olive Blvd
Chesterfield, MO 63017
Phone (636) 532-1515

109 N Keene St
Columbia, MO 65201
Phone (573) 443-2007

550 Stone Valley Pkwy
Columbia, MO 65203
Phone (573) 527-3836

2333 Chapel Hill Rd
Columbia, MO 65203
Phone (573) 234-1091

3343 Armbruster Rd
De Soto, MO 63020
Phone (636) 586-2188

16219 Autumn View Terrace Dr
Ellisville, MO 63011
Phone (314) 993-9888

15826 Clayton Rd
Ellisville, MO 63011
Phone (314) 737-4629

200 Maple Valley Dr
Farmington, MO 63640
Phone (573) 260-1678

1827 Crader Dr
Jefferson City, MO 65109
Phone (573) 635-0023

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

9601 N Tullis Dr
Kansas City, MO 64157
Phone (816) 342-4112

842 Lynn St
Lebanon, MO 65536
Phone (417) 219-3949

24 Trenshaw Trl
Linn, MO 65051

1538 N Old Castle Rd
Nixa, MO 65714
Phone (417) 724-8188

135 Meadowlands Estates Ln
O Fallon, MO 63366
Phone (636) 614-0036

707 Emge Rd
O Fallon, MO 63366
Phone (636) 240-6152

1030 Barathaven Dr
O Fallon, MO 63368
Phone (636) 329-9160

10441 International Plaza Dr
Saint Ann, MO 63074
Phone (314) 423-0600

35 Lillian Dr
Saint Charles, MO 63304
Phone (636) 345-1782

1000 Landing Cir
Saint Charles, MO 63304
Phone (636) 669-0799

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

Organizations & group practices 5

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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1215711536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E YOUNG AVE",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640939609",
            "telephone_number": "660-747-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E YOUNG AVE UNIT B1-2",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640939609",
            "telephone_number": "660-747-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVICKER",
        "first_name": "KENNEDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022043948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.