Theodora J Stevens, DPT
Individual provider Active NPI Physical Therapist · Wichita, KS
NPI 1306282264 · NPPES record last updated Dec 2, 2013
Key facts
- NPI
- 1306282264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-04621 (KS)
- Practice address
- 750 N Socora St
Ste 400
Wichita, KS 67212-3793 - Phone
- (316) 440-3731
- Fax
- (316) 440-3741
- NPI assigned
- May 20, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced PT LLC
Practice addresses (Care Compare)
3730 N Ridge Rd
Suite 500
Wichita, KS 67205-1233
Phone (316) 440-4901
4515 E Central Ave
Suite a
Wichita, KS 67208-3915
Phone (316) 260-6869
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130924000662 | KS | Practitioner - Physical Therapist in Private Practice | 9537303946 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-04621 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced PT LLC | Physical Therapist | Current |
Accepting new patients |
| Advanced PT LLC | Physical Therapist | Current | Accepting new patients |
| Advanced PT LLC | Physical Therapist | Current |
Accepting new patients |
| Advanced PT Pca, LLC | Physical Therapist | Past | Accepting new patients |
Locations
400 W 4th St
McPherson, KS 67460
Phone (620) 241-4201
315 W Washington Ave
Sterling, KS 67579
Phone (620) 204-6116
200 W Douglas Ave
Ste 1040
Wichita, KS 67202
Phone (866) 412-5554
3730 N Ridge Rd
Ste 500
Wichita, KS 67205
Phone (316) 440-4901
6940 W Newell St
Wichita, KS 67212
Phone (316) 440-3731
4515 E Central Ave
Ste A
Wichita, KS 67208
Phone (316) 260-6869
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-04621 | KS | Yes |
Addresses
Primary practice location
750 N Socora St
Ste 400
Wichita, KS 67212-3793
Mailing address
200 W Douglas Ave
Ste 1040
Wichita, KS 67202-3013
Phone (316) 263-0003
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.