NPIMap

Organization Active NPI

Complete PT, LLC

  • Physical Therapy Clinic/Center
  • Liberty, MO
National Provider Identifier
1790214252
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
COMPLETE PT, LLC
Practice address
102 S Forrest Ave
Liberty, MO 64068-1908
Phone
(515) 341-2721
NPI assigned
Jun 8, 2017
Last updated
Sep 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Authorized official

Name
Dr. Gary Dwayne Eichenberger, DPTNPI 1154610186
Title
Physical Therapist/ Owner
Phone
(515) 341-2721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MO Primary

Addresses

Primary practice location

102 S Forrest Ave
Liberty, MO 64068-1908

Mailing address

8305 NE 105TH St
Kansas City, MO 64157-9102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170919000714 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2062786825 Receives reassigned benefits from 4 practitioners
Practice locations: Liberty, MO

National Provider Directory

National Provider Directory

Locations

1005 N State Route 291
Liberty, MO 64068
Phone (816) 429-5199

102 S Forrest Ave
Liberty, MO 64068
Phone (515) 341-2721

Practitioners & affiliated clinicians

Practitioners 8

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": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1790214252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 NE 105TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641579102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S FORREST AVE",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681908",
            "telephone_number": "515-341-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "EICHENBERGER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/ OWNER",
        "authorized_official_telephone_number": "515-341-2721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.