Active NPI
Julia A Kellogg, PT, CHT
- Physical Therapist
- Wentzville, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01829
- Practice address
- 1428 W Meyer Rd
Wentzville, MO 63385-3499 - Phone
- (636) 887-3660
- Fax
- (636) 887-3661
- NPI assigned
- May 17, 2006
- Last updated
- Jul 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 01829 | MO | Primary |
| Hand Physical Therapist | 2251H1200X | 9611000171 | MO |
Addresses
Primary practice location
1428 W Meyer Rd
Wentzville, MO 63385-3499
Mailing address
607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504-7335
Phone (616) 356-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00609549 | Other | MO | RAILROAD MEDICARE |
| 12325956 | Other | MO | CAQH ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1428 W Meyer Rd
Wentzville, MO 63385-3499
Phone (636) 887-3660
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9611000171 | MO | MD | Hand Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Babar Enterprises LLC | Physical Therapist | Current | Accepting new patients |
| Babar Enterprises LLC | Physical Therapist | Past | Accepting new patients |
| Babar Enterprises LLC | Physical Therapist | Past | Accepting new patients |
Locations
2982 Highway K
O Fallon, MO 63368
Phone (636) 978-5255
2454 W Clay St
Saint Charles, MO 63301
Phone (636) 916-4625
4625 Lindell Blvd
Ste 510
Saint Louis, MO 63108
Phone (314) 367-7450
713 N New Ballas Rd
Saint Louis, MO 63141
Phone (314) 991-0480
4800 Mexico Rd
Ste 104
Saint Peters, MO 63376
Phone (636) 916-4625
605 E Booneslick Rd
Ste 3
Warrenton, MO 63383
Phone (636) 456-6350
1428 W Meyer Rd
Wentzville, MO 63385
Phone (636) 887-3660
Organizations & group practices 3
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.
-
dba Excel Sports & Physical Therapy
- Physical Therapist
- Creve Coeur, MO
- NPI 1033178827
-
dba Excel Sports and Physical Therapy
- Physical Therapist
- O'Fallon, MO
- NPI 1053576512
-
dba Excel Sports and Physical Therapy
- Physical Therapist
- Warrenton, MO
- NPI 1548425002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469404800000",
"number": "1679525570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 DEWEY AVE NW",
"address_2": "STE 300",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495047335",
"telephone_number": "616-356-5000",
"fax_number": "616-356-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1428 W MEYER RD",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "633853499",
"telephone_number": "636-887-3660",
"fax_number": "636-887-3661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLOGG",
"first_name": "JULIA",
"middle_name": "A",
"credential": "PT, CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2016-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "01829",
"primary": true
},
{
"code": "2251H1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Hand",
"state": "MO",
"license": "9611000171",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00609549",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID",
"identifier": "12325956",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wentzville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.