Individual provider Active NPI

Marikay Lou Asberry, MSPT/ATC

  • Physical Therapist
  • Rolla, MO
National Provider Identifier
1699724351
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT109661 Issued in MO
Practice address
906 N Cedar St
Rolla, MO 65401-3350
Phone
(573) 338-0999
Fax
(573) 368-2777
NPI assigned
May 9, 2006
Last updated
Aug 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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 PT109661 MO Primary

Addresses

Primary practice location

906 N Cedar St
Rolla, MO 65401-3350

Mailing address

906 N Cedar St
Rolla, MO 65401-3350
Phone (573) 338-0999

Other identifiers 1

IdentifierTypeStateIssuer
484018700MedicaidMO

Other names 1

  • Marikay Lou Kadlec Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000839 MO Practitioner - Physical Therapist in Private Practice 6507058393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Missouri Physical Therapy LLCGroup PAC ID 6901870187, 59 clinicians
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone (573) 449-8771

601 Kingshighway St
Suite a
Rolla, MO 65401-2927
Phone (573) 368-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT109661MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Boone Physician Services, LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

601 Kingshighway St
Ste A
Rolla, MO 65401
Phone (573) 368-0999

Organizations & group practices 2

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1699724351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 N CEDAR ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013350",
            "telephone_number": "573-338-0999",
            "fax_number": "573-368-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N CEDAR ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013350",
            "telephone_number": "573-338-0999",
            "fax_number": "573-368-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASBERRY",
        "first_name": "MARIKAY",
        "middle_name": "LOU",
        "credential": "MSPT/ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "PT109661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "484018700",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIKAY",
            "last_name": "KADLEC",
            "middle_name": "LOU",
            "credential": "MSPT/ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.