Individual provider Active NPI

Todd M Ankenman, PT

  • Physical Therapist
  • Columbia, MO
National Provider Identifier
1386675676
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02216 Issued in MO
Practice address
3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone
(573) 449-8771
Fax
(573) 449-6563
NPI assigned
Jul 5, 2006
Last updated
Mar 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02216 MO Primary
Athletic Trainer 2255A2300X 111268 MO

Addresses

Primary practice location

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517

Mailing address

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone (573) 449-8771

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060815000121 MO Practitioner - Physical Therapist in Private Practice 7315940434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
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)

2003 W Broadway
Suite 105
Columbia, MO 65203-1111
Phone (573) 474-5111

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone (573) 449-8771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02216MOMDPhysical Therapist
111268MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince Nov 1, 2014 Accepting new patients
Boone Physician Services, LLC CurrentSince Aug 1, 2023 Accepting new patients
Brookfield Physical Therapy,Inc. Physical Therapist Past Accepting new patients
Chas Physician Services LLC Past Accepting new patients
Malloy Holdings, LLC Past Accepting new patients
Northland Physical Therapy & Rehab Services, Inc Physical Therapist PastSince Nov 1, 2018 Accepting new patients
BDM Associates LLC Physical Therapist Past Accepting new patients
Central Physical Rehabilitation and Sports Medicine, LLC Physical Therapist PastSince Feb 1, 2017 Accepting new patients

Locations

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

1605 E Broadway
Ste 300
Columbia, MO 65201
Phone (573) 256-7700

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

2003 W Broadway
Ste 105
Columbia, MO 65203
Phone (573) 474-5111

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

2625 Fairway Dr
Ste C
Fulton, MO 65251
Phone (573) 592-7750

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

777 S New Ballas Rd
Ste 218E
Saint Louis, MO 63141
Phone (314) 681-2800

3222 W 16th St
Sedalia, MO 65301
Phone (660) 827-6800

Organizations & group practices 8

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1386675676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-8771",
            "fax_number": "573-449-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-8771",
            "fax_number": "573-449-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKENMAN",
        "first_name": "TODD",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "02216",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "111268",
            "primary": false
        }
    ],
    "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 Mar 18, 2015; 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.