Kallie O'Dell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2016027708 Issued in MO

Practice address

925 Felix St
Saint Joseph, MO 64501-2788

Phone

(816) 671-4007

Fax

(816) 671-4470

NPI assigned

Aug 11, 2016

Last updated

Sep 23, 2020By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1861946469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N FRANKLIN ST",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640839571",
            "telephone_number": "816-261-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 FELIX ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645012788",
            "telephone_number": "816-671-4007",
            "fax_number": "816-671-4470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Osage Beach",
            "state": "MO",
            "postal_code": "650653050",
            "country_code": "US",
            "telephone_number": "573-374-8885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "KALLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016027708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.