Individual provider Active NPI

Logan Marie Kroenke, PT, DPT

  • Physical Therapist
  • Warrensburg, MO
National Provider Identifier
1275114183
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2021035533 Issued in MO
Practice address
540 E Young Ave Ste E
Warrensburg, MO 64093-1250
Phone
(660) 262-4795
Fax
(660) 747-0347
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 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 2021035533 MO Primary

Addresses

Primary practice location

540 E Young Ave Ste E
Warrensburg, MO 64093-1250

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other names 1

  • Logan Marie McKenna Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210902003317 MO Practitioner - Physical Therapist in Private Practice 3971909631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

159 SW Hwy 150
Lees Summit, MO 64082-4402
Phone (816) 944-3003

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince May 13, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 13, 2024 Accepting new patients
Serc Rehabilitation Partners, LLC Physical Therapist CurrentSince Aug 31, 2021 Accepting new patients
Serc Rebabilitation Partners, LLC Physical Therapist CurrentSince Aug 31, 2021 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051

109 W Franklin St
Clinton, MO 64735
Phone (660) 383-1280

159 SW Highway 150
Lees Summit, MO 64082
Phone (816) 944-3003

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

540 E Young Ave
Ste E
Warrensburg, MO 64093
Phone (660) 262-4795

540 E Young Ave
Warrensburg, MO 64093
Phone (660) 262-4795

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: logan.kroenke.p9@direct.athleticoltd.nextgenshare.com

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": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1275114183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E YOUNG AVE STE E",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931250",
            "telephone_number": "660-262-4795",
            "fax_number": "660-747-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENKE",
        "first_name": "LOGAN",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021035533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "MCKENNA",
            "middle_name": "MARIE",
            "credential": "PT,DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 10, 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.