Organization Active NPI

Exceed Physical Therapy LLC

  • Physical Therapist
  • Kahoka, MO
National Provider Identifier
1700912276
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
117019 Issued in MO
Legal business name
EXCEED PHYSICAL THERAPY LLC
Practice address
120 South Johnson Street
Kahoka, MO 63445
Phone
(660) 727-2722
Fax
(660) 727-2725
NPI assigned
Feb 26, 2007
Last updated
Jul 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Shay Winters
Title
Manager
Phone
(660) 727-2722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 117019 MO Primary

Addresses

Primary practice location

120 South Johnson Street
Kahoka, MO 63445

Mailing address

120 South Johnson Street
Kahoka, MO 63445
Phone (660) 727-2722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000059 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395836605 Receives reassigned benefits from 1 practitioner
Practice locations: Kahoka, MO

National Provider Directory

National Provider Directory

Locations

120 S Johnson St
Kahoka, MO 63445
Phone (660) 342-8351

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1700912276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SOUTH JOHNSON STREET",
            "city": "KAHOKA",
            "state": "MO",
            "postal_code": "63445",
            "telephone_number": "660-727-2722",
            "fax_number": "660-727-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTH JOHNSON STREET",
            "city": "KAHOKA",
            "state": "MO",
            "postal_code": "63445",
            "telephone_number": "660-727-2722",
            "fax_number": "660-727-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEED PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "SHAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "660-727-2722"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "117019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahoka, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.