Individual provider Active NPI

Kaylee Tagart, PT

  • Physical Therapist
  • Fulton, MO
National Provider Identifier
1679146328
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2023018150 Issued in MO
Practice address
366 Country Meadow LN
Fulton, MO 65251-5278
Phone
(573) 642-7216
NPI assigned
Jul 21, 2021
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2023018150 MO Primary

Addresses

Primary practice location

366 Country Meadow LN
Fulton, MO 65251-5278

Mailing address

366 Country Meadow LN
Fulton, MO 65251-5278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802001867 MO Practitioner - Physical Therapist in Private Practice 6002214590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

366 Country Meadow LN
Fulton, MO 65251-5278
Phone (573) 642-7216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023018150MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Aug 1, 2023 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Aug 1, 2023 Accepting new patients
Select Physical Therapy Holdings Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

155 Siemers Dr
Ste 8
Cape Girardeau, MO 63701
Phone (573) 334-6711

200 N Keene St
Columbia, MO 65201
Phone (573) 874-0001

366 Country Meadow Ln
Fulton, MO 65251
Phone (573) 642-7216

366 Country Meadow Ln
Ste D
Fulton, MO 65251

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1679146328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 COUNTRY MEADOW LN",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652515278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 COUNTRY MEADOW LN",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652515278",
            "telephone_number": "573-642-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGART",
        "first_name": "KAYLEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2023018150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.