Kellie L Blow, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2016003540 Issued in MO

Practice address

784 Gravois Bluffs Blvd
Fenton, MO 63026-7726

Phone

(636) 349-8060

Fax

(636) 349-9171

NPI assigned

Feb 11, 2016

Last updated

Jan 13, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kellie L Mills Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kellie.mills.p2@direct.athleticoltd.nextgenshare.com

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1750740379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 GRAVOIS BLUFFS BLVD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267726",
            "telephone_number": "636-349-8060",
            "fax_number": "636-349-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOW",
        "first_name": "KELLIE",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016003540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "MILLS",
            "middle_name": "L",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katherine A. Blackburn, M.A.
• Joseph A. Blaes, DDS
• Danielle Rebecca Blake
• April Louise Blandford, DPT
• Diane Denise Block, NP
• Michael Scott Boedefeld, MD
• Emily Bohnert
• Bon Vivant Adult Day Club L.L.C.
• Susan Elizabeth Bonk, MS, CCC-SLP
• Nicole M Book, MS, LPC

• Physical Therapist in Fenton, MO
• Providers in Fenton, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.