Individual provider Active NPI

James Ryan King, PT, DPT

  • Physical Therapist
  • Palmyra, MO
National Provider Identifier
1649047499
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022030887 Issued in MO
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 4 clinicians

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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
2022030887MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
K.B. Therapy, Inc. Physical Therapist CurrentSince Jan 8, 2024 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)CodeLicenseStatePrimary
Physical Therapist 225100000X 2022030887 MO Primary

Addresses

NPPES NPI Registry

Primary 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.

Verify at the official NPI Registry.