Tarah Judith an Phongsavath, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-07644 Issued in KS

Practice address

601 E 63Rd St
Kansas City, MO 64110-3303

Phone

(816) 569-2802

Fax

(816) 569-5436

NPI assigned

Jul 19, 2024

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

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Foundational Concepts IncGroup PAC ID 2961648126, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundational Concepts, Inc.

  • Physical Therapy Clinic/Center
  • Kansas City, MO
  • NPI 1598008294

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1780422006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24850 W 191ST ST",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "660309402",
            "telephone_number": "913-549-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 63RD ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103303",
            "telephone_number": "816-569-2802",
            "fax_number": "816-569-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHONGSAVATH",
        "first_name": "TARAH",
        "middle_name": "JUDITH AN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-07644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tess Phillips
• Thomas P Phillips, M.D.
• PHKC Cleveland, LLC
• PHKC Swope, LLC
• Phoenix HMR Holdings
• Physicians Reference Laboratory LLC
• Physicians Reference Laboratory LLC
• Physicians Reference Laboratory LLC
• Physicians' Health Care Consulting, Inc.
• Physio Lab KC, LLC

• Physical Therapist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.