Kerri Anne Wallace, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2008036904 Issued in MO

Practice address

324 W 5TH St
Washington, MO 63090-2306

Phone

(636) 239-7848

NPI assigned

May 26, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kerri Anne Flaugher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Missouri Baptist Hospital of Sullivan

  • Ambulance
  • Sullivan, MO
  • NPI 1831343268
  NPD (past)

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1619260478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 W MAIN ST",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630801911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902306",
            "telephone_number": "636-239-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KERRI",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2008036904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRI",
            "last_name": "FLAUGHER",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Walk, FNP
• Walkenhorst Senior Care, LLC
• Roger Wells Walkenhorst, DDS
• David Walker, PHARMD
• Katherine C Walker, LPC, NCC
• Walton CS-Xiii
• Timothy James Warren, M.D.
• Washington Area Ambulance District
• Washington Chiropractic Clinic PC
• Washington Community Counseling Center

• Physical Therapist in Washington, MO
• Providers in Washington, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.