Carly Lenzen, DPT

Individual provider Active NPI Physical Therapist · Willard, MO

NPI 1609674969 · NPPES record last updated Mar 4, 2025

Key facts

NPI
1609674969
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2022030880 (MO)
Practice address
304 E Jackson St Ste 2F
Willard, MO 65781-9472
Phone
(417) 221-4667
Fax
(417) 744-9674
NPI assigned
Mar 4, 2025
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willard Physical Therapy Center LLC (6 clinicians)

Practice addresses (Care Compare)

304 E Jackson St
Suite 2F
Willard, MO 65781-9333
Phone (417) 221-4667

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250603002907 MO Practitioner - Physical Therapist in Private Practice 8628587433 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Willard Physical Therapy Center LLC Physical Therapist Current
since Mar 16, 2025
Accepting new patients

Locations

304 E Jackson St
Ste 2F
Willard, MO 65781
Phone (417) 221-4667

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2022030880 MO Yes

Addresses

Primary practice location

304 E Jackson St Ste 2F
Willard, MO 65781-9472

Mailing address

3811 S Weller Ave Apt A207
Springfield, MO 65804-5248
Phone (480) 710-4523

Other providers in Willard, MO

All providers in Willard, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.