Individual provider Active NPI

Kate Selsby Revill, DPM

  • Foot & Ankle Surgery Podiatrist
  • Gladstone, MO
National Provider Identifier
1427362946
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2013035885 Issued in MO
Practice address
407 NE 76TH Ter
Gladstone, MO 64118-1708
Phone
(816) 436-7900
Fax
(816) 436-0999
NPI assigned
Jul 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2013035885 MO Primary

Addresses

Primary practice location

407 NE 76TH Ter
Gladstone, MO 64118-1708

Mailing address

18080 Beach Blvd 103
Huntington Beach, CA 92648-1343
Phone (714) 596-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Foot and Ankle Specialists, Inc Foot & Ankle Surgery CurrentSince Dec 21, 2015 Accepting new patients

Locations

410 16th Ave
San Francisco, CA 94118
Phone (415) 387-7333

Organizations & group practices 1

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1427362946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18080 BEACH BLVD 103",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481343",
            "telephone_number": "714-596-8800",
            "fax_number": "714-596-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 NE 76TH TER",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641181708",
            "telephone_number": "816-436-7900",
            "fax_number": "816-436-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVILL",
        "first_name": "KATE",
        "middle_name": "SELSBY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2013035885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.