Richard M Kidwell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

00714 Issued in MO

Practice address

1555 Timberlake Manor Pkwy
Chesterfield, MO 63017-5584

Phone

(636) 778-0584

NPI assigned

Sep 21, 2007

Last updated

Sep 21, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopaedic & Sports Physical Therapy, Inc.

  dba Telegraph Road Physical Therapy

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
  • NPI 1649313594

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1669668828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 TIMBERLAKE MANOR PKWY",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175584",
            "telephone_number": "636-778-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 TIMBERLAKE MANOR PKWY",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175584",
            "telephone_number": "636-778-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "00714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jevinne Khan, DC
• Kanwal Khan, M.D.
• Wagmah Javed Khan, MD
• Prajakta Khare, MSC, RDN, LD
• Matthew James Kiblinger, MD
• Joshua A Kilpatrick, D.C
• David Yunhu Kim, PHARM.D.
• Sung Ho Kim, D.D.S.
• Thomas Kim, MD
• Wonmin Kim

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.