Active NPI
James Ryan King, PT, DPT
- Physical Therapist
- Palmyra, MO
National Provider Identifier
1649047499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2022030887
- Practice address
- 1219 S Main St
Palmyra, MO 63461-1943 - Phone
- (573) 769-6166
- Fax
- (573) 769-2356
- NPI assigned
- Dec 11, 2023
- Sex
- Male
- 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.
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- K.B. Therapy Inc
Practice addresses (Care Compare)
1219 S Main St Box
Suite 208
Palmyra, MO 63461-0208
Phone (573) 769-6166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240105001035 | MO | Practitioner - Physical Therapist in Private Practice | 9032560818 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022030887 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K.B. Therapy, Inc. | Physical Therapist | Current | Accepting new patients |
Locations
1219 S Main St
Palmyra, MO 63461
Phone (573) 769-3480
1219 S Main St
#208
Palmyra, MO 63461
Phone (573) 769-6166
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2022030887 | MO | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1219 S Main St
Palmyra, MO 63461-1943
Mailing address
PO Box 208
Palmyra, MO 63461-0208
Phone (573) 769-6166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 11, 2023.
{
"created_epoch": "1702252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1649047499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 208",
"city": "PALMYRA",
"state": "MO",
"postal_code": "634610208",
"telephone_number": "573-769-6166",
"fax_number": "573-769-2356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 S MAIN ST",
"city": "PALMYRA",
"state": "MO",
"postal_code": "634611943",
"telephone_number": "573-769-6166",
"fax_number": "573-769-2356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JAMES",
"middle_name": "RYAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-12-11",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2022030887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palmyra, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.