Individual provider Active NPI

Jessica Dawn Clutter, PT

  • Physical Therapist
  • Platte City, MO
National Provider Identifier
1750721734
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2012037659 Issued in MO
Practice address
2425 NW Prairie View Rd
Platte City, MO 64079-7627
Phone
(816) 858-2368
Fax
(816) 858-2214
NPI assigned
Jul 5, 2013
Last updated
Jul 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 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 2012037659 MO Primary

Addresses

Primary practice location

2425 NW Prairie View Rd
Platte City, MO 64079-7627

Mailing address

2425 NW Prairie View Rd
Platte City, MO 64079-7627
Phone (816) 858-2368

Other names 1

  • Jessica Dawn Alford Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409000915 MO Practitioner - Physical Therapist in Private Practice 1456780618 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1051 Kent St
Liberty, MO 64068-2257
Phone (816) 370-5242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince May 17, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Mar 18, 2020 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince May 12, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince May 12, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Mar 18, 2020 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

16255 Chesterfield Pkwy W
Chesterfield, MO 63017
Phone (636) 812-6942

3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767

2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

1131 E Lakewood St
Springfield, MO 65810
Phone (417) 429-3666

Organizations & group practices 7

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": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1750721734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 NW PRAIRIE VIEW RD",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797627",
            "telephone_number": "816-858-2368",
            "fax_number": "816-858-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 NW PRAIRIE VIEW RD",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797627",
            "telephone_number": "816-858-2368",
            "fax_number": "816-858-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUTTER",
        "first_name": "JESSICA",
        "middle_name": "DAWN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012037659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ALFORD",
            "middle_name": "DAWN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Platte City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.