Individual provider Active NPI

Katelyn Foley, DPT

  • Physical Therapist
  • Columbia, MO
National Provider Identifier
1366043630
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2020035154 Issued in MO
Practice address
3301 Berrywood Dr Ste 204
Columbia, MO 65201-6517
Phone
(573) 449-6082
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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 2020035154 MO Primary

Addresses

Primary practice location

3301 Berrywood Dr Ste 204
Columbia, MO 65201-6517

Mailing address

4755 W East Ridge Rd
Columbia, MO 65202-7178
Phone (573) 823-8035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201120002054 MO Practitioner - Physical Therapist in Private Practice 1850702952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Missouri Physical Therapy LLCGroup PAC ID 6901870187, 59 clinicians
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1705 Christy Dr
Suite 200
Jefferson City, MO 65101-5195
Phone (573) 659-5515

601 Kingshighway St
Suite a
Rolla, MO 65401-2927
Phone (573) 368-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Aug 1, 2023 Accepting new patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients

Locations

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 Christy Dr
Ste 200
Jefferson Cty, MO 65101
Phone (573) 634-3338

601 Kingshighway St
Ste A
Rolla, MO 65401
Phone (573) 368-0999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1366043630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 W EAST RIDGE RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652027178",
            "telephone_number": "573-823-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR STE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "KATELYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020035154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.