Kelly Lynn Munson
Individual provider Active NPI Spinal Cord Injury Medicine Physician · Lemay, MO
NPI 1609427178 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1609427178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Spinal Cord Injury Medicine Physician 2081P0004X
- License
- 2010023603 (MO)
- Practice address
- 1 Jefferson Barracks Dr
Lemay, MO 63125-4181 - Phone
- (314) 210-1909
- NPI assigned
- Sep 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- RWW Outpatient Rehab Services, LLC
Practice addresses (Care Compare)
2892 S Church St
Unit a
Murfreesboro, TN 37127-6374
Phone (615) 447-9520
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230608001388 | TN | Practitioner - Occupational Therapist in Private Practice | 4082071980 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010023603 | MO | MD | Spinal Cord Injury Medicine Physician |
| 6727 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RWW Outpatient Rehab Services, LLC | Current | Accepting new patients | |
| RWW Outpatient Rehab Services, LLC | Current |
Accepting new patients | |
| RWW Outpatient Rehab Services, LLC | Current |
Accepting new patients |
Locations
805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438
105 Glen Oak Blvd
Ste 101
Hendersonvlle, TN 37075
Phone (615) 826-6612
2892 S Church St
Ste A
Murfreesboro, TN 37127
Phone (615) 447-9520
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Spinal Cord Injury Medicine Physician | 2081P0004X | 2010023603 | MO | Yes |
Addresses
Primary practice location
1 Jefferson Barracks Dr
Lemay, MO 63125-4181
Mailing address
1750 Tuscany Way
Brentwood, TN 37027-0501
Phone (314) 304-0379
Other providers in Lemay, MO
- Erin Paige Mannion
- Mercy Pharmacy Services LLC
- Motivate Healthcare in Home LLC
- Motivate Healthcare in-Home LLC
- Motivate Healthcare LLC
All providers in Lemay, MO · Spinal Cord Injury Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. 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.