Individual provider Active NPI

Katie Louise Riedell, PT, DPT

  • Physical Therapist
  • Raymore, MO
National Provider Identifier
1316697345
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2026018143 Issued in MO
Practice address
121 N Dean Ave Ste 102
Raymore, MO 64083-8398
Phone
(816) 441-5656
Fax
(913) 745-4352
NPI assigned
Mar 24, 2022
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 2026018143 MO Primary

Addresses

Primary practice location

121 N Dean Ave Ste 102
Raymore, MO 64083-8398

Mailing address

22120 Midland Dr Ste 1
Shawnee, KS 66226-3554
Phone (913) 351-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220525002223 AK Practitioner - Physical Therapist in Private Practice 8729466149 Reassigns benefits to 1 organization
I20260519000692 MO Practitioner - Physical Therapist in Private Practice 8729466149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Fit Muscle and Joint Clinic LLCGroup PAC ID 5991935579, 54 clinicians
Wasilla Physical Therapy Inc.Group PAC ID 1456504448, 4 clinicians

Practice addresses (Care Compare)

121 N Dean Ave
Suite 102
Raymore, MO 64083-8398
Phone (816) 441-5656

3750 E Country Field Cir
Suite a
Wasilla, AK 99654-6659
Phone (907) 376-7334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2026018143MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fit Muscle & Joint Clinic LLC Physical Therapist CurrentSince May 1, 2026 Accepting new patients

Locations

121 N Dean Ave
Ste 102
Raymore, MO 64083
Phone (816) 441-5656

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1316697345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22120 MIDLAND DR STE 1",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263554",
            "telephone_number": "913-351-2710",
            "fax_number": "913-745-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N DEAN AVE STE 102",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838398",
            "telephone_number": "816-441-5656",
            "fax_number": "913-745-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDELL",
        "first_name": "KATIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2026018143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.