Corrie Lynn Graves Tice, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20000152219 Issued in MO

Practice address

2727 Tracy Ave
Kansas City, MO 64109-1243

Phone

(816) 889-3502

NPI assigned

Aug 16, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Corrie Lynn Graves Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1295040186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NE 83RD TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641181253",
            "telephone_number": "816-420-9901",
            "fax_number": "816-420-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 TRACY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641091243",
            "telephone_number": "816-889-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "CORRIE LYNN",
        "middle_name": "GRAVES",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "20000152219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRIE",
            "last_name": "GRAVES",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• THVC Services of Mo PC
• Garrett Tibbets
• Ashley Tibbett
• Chelsea Nichole Tibbetts, DHED, MS, MA
• Amy Marie Tibbitts, LCSW
• Jordan J Tice, DDS, MHA
• Kerri Ann Tidwell, MSN, RN
• Victoria Danelle Tidwell
• James Tiehen, M.D.
• Jennifer Tieman, M.D.

• Physical Therapist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.