Kimberly Ann Bunten, P.T.
Individual provider Active NPI Physical Therapist · Palmyra, MO
NPI 1376677682 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1376677682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- R1127 (MO)
- Practice address
- 1219 S Main St
Palmyra, MO 63461-1943 - Phone
- (573) 769-6166
- Fax
- (573) 769-2356
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- K.B. Therapy Inc
LH Therapy LLC
Practice addresses (Care Compare)
1219 S Main St Box
Suite 208
Palmyra, MO 63461-0208
Phone (573) 769-6166
2521 S Cashua Dr
Florence, SC 29501-5305
Phone (843) 536-4888
2521 S Cashua Dr
Florence, SC 29501-5350
Phone (843) 536-4888
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100901001003 | MO | Practitioner - Physical Therapist in Private Practice | 8022060136 | Reassigns benefits to 1 organization |
| I20161101000054 | SC | Practitioner - Physical Therapist in Private Practice | 8022060136 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7925 | SC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K.B. Therapy, Inc. | Physical Therapist | Current |
Accepting new patients |
| LH Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| K.B.Therapy, Inc. | Physical Therapist | Current | Accepting new patients |
Locations
1219 S Main St
Palmyra, MO 63461
Phone (573) 769-3480
1219 S Main St
#208
Palmyra, MO 63461
Phone (573) 769-6166
2521 S Cashua Dr
Florence, SC 29501
Phone (843) 536-4888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | R1127 | MO | Yes |
| Physical Therapist | 225100000X | 7925 | SC |
Addresses
Primary practice location
1219 S Main St
Palmyra, MO 63461-1943
Mailing address
PO Box 208
Palmyra, MO 63461-1923
Phone (573) 769-1066
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 483875811 | Medicaid | MO |
Other providers in Palmyra, MO
- Blankenship Residentail Care Center, LLC
- Blessing Corporate Services Inc
- Blessing Hospital
- Blessing Hospital
- Bristol Care, Inc.
- Deidra F Cole
- Family Chiropractic Care, Inc.
- Amanda Elizabeth Gottman
- Amber Nicole Gottman
- Irina Nicole Gottman
All providers in Palmyra, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.