Kendra Leanne Shull
Individual provider Active NPI Physical Therapist · Lexington, MO
NPI 1740545367 · NPPES record last updated Jul 10, 2012
Key facts
- NPI
- 1740545367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2009023139 (MO)
- Practice address
- 2323A High School Dr
Special Services - Claim Care
Lexington, MO 64067-1525 - Phone
- (660) 259-4369
- Fax
- (660) 259-4992
- NPI assigned
- Jul 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
536 S Business Hwy 13
Lexington, MO 64067-1438
Phone (660) 251-2101
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190709000424 | MO | Practitioner - Physical Therapist in Private Practice | 5991030355 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009023139 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundations Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Lexington School Dixt RV | Physical Therapist | Past | Accepting new patients |
Locations
536 S Business Highway 13
Lexington, MO 64067
Phone (660) 251-2101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2009023139 | MO | Yes |
Addresses
Primary practice location
2323A High School Dr
Special Services - Claim Care
Lexington, MO 64067-1525
Mailing address
2323A High School Dr
Special Services - Claim Care
Lexington, MO 64067-1525
Phone (660) 259-4369
Other providers in Lexington, MO
- Riverbend Heights Health & Rehabilitation LLC
- Samuel U. Rodgers Health Center, Inc
- Samuel U. Rodgers Health Center, Inc.
- Jeffrey W Sattler
- Mary Beth Schnell
- Dena M Skinner
- Theresa Slana
- Adeane Sollars
- SRZ Op Riverbend LLC
- Margaret A. Stockton
All providers in Lexington, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.