Individual provider Active NPI

Chenin Marie Roudebush, PT, DPT

  • Physical Therapist
  • Kansas City, MO
National Provider Identifier
1477911097
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2026038783 Issued in MO
Practice address
3215 Main St
Kansas City, MO 64111-2645
Phone
(816) 472-1800
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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 2026038783 MO Primary
Physical Therapist 225100000X 303004 CA

Addresses

Primary practice location

3215 Main St
Kansas City, MO 64111-2645

Mailing address

3215 Main St
Kansas City, MO 64111-2645

Other names 1

  • Chenin Marie Young Former name

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

State licenses

LicenseStateTypeSpecialty
303004CAMDPhysical Therapist
1272137TXMDPhysical Therapist
16435NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1477911097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 MAIN ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 MAIN ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112645",
            "telephone_number": "816-472-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUDEBUSH",
        "first_name": "CHENIN",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2026038783",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHENIN",
            "last_name": "YOUNG",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.