Robert Alan Mitchell, PT, BSPT
Individual provider Active NPI Physical Therapist · Riverside, MO
NPI 1801847124 · NPPES record last updated May 8, 2018
Key facts
- NPI
- 1801847124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 103074 (MO)
- Practice address
- 220 NW Platte Valley Dr
Riverside, MO 64150-9793 - Phone
- (816) 741-6374
- Fax
- (816) 505-3312
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Serc Rebabilitation Partners, LLC
Practice addresses (Care Compare)
220 NW Platte Valley Dr
Serc KC North
Riverside, MO 64150-9793
Phone (816) 741-6374
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090126000362 | MO | Practitioner - Physical Therapist in Private Practice | 0345138939 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serc Rebabilitation Partners, LLC | Physical Therapist | Current |
Accepting new patients |
| Serc Rehabilitation Partners, LLC | Current |
Accepting new patients | |
| Serc Rehabilitation Partners, LLC | Physical Therapist | Current | Accepting new patients |
| Spine and Extremity Rehabilitation Center of Raytown Inc | Physical Therapist | Past | Accepting new patients |
| Mid America Balance Institute of Clay Platte County Missouri | Past | Accepting new patients | |
| Mid America Balance Institute of Cass County Missouri | Past | Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051
109 W Franklin St
Clinton, MO 64735
Phone (660) 383-1280
220 NW Platte Valley Dr
Riverside, MO 64150
Phone (816) 505-3422
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 103074 | MO | Yes |
Addresses
Primary practice location
220 NW Platte Valley Dr
Riverside, MO 64150-9793
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27955092 | Other | BCBS KC | |
| MA437022 | Other | MO | MEDICARE PTAN |
Other providers in Riverside, MO
- Brian Martin Matthys
- Medical One Inc
- Molly Bea Menser
- Meritas Health Occupational Medicine, Inc
- Michael D Arnett, DDS, PC
- Brittany Neri
- Morgan Lyn Newman
- Kirsten Osei
- Krishna Patel
- Phillips Family Pharmacy, LLC
All providers in Riverside, 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 May 8, 2018. 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.