Active NPI
Jordan Fohey
- Physical Therapist
- Liberty, MO
National Provider Identifier
1477934800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2015017610
- Practice address
- 2105 Kara CT
Suite A1
Liberty, MO 64068-1392 - Phone
- (816) 407-1249
- NPI assigned
- Jun 11, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2015017610 | MO | Primary |
Addresses
Primary practice location
2105 Kara CT
Suite A1
Liberty, MO 64068-1392
Mailing address
2105 Kara CT
Ste 1-a
Liberty, MO 64068-1395
Phone (816) 407-1249
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2015017610 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457654400000",
"number": "1477934800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 KARA CT",
"address_2": "STE 1-A",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640681395",
"telephone_number": "816-407-1249",
"fax_number": "816-407-1259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 KARA CT",
"address_2": "SUITE A1",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640681392",
"telephone_number": "816-407-1249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOHEY",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-11",
"last_updated": "2016-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2015017610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.