Active NPI
Kimberly Renee Fortuna, PT
- Physical Therapist
- Excelsior Springs, MO
National Provider Identifier
1871055004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02139
- Practice address
- 940 Holly St
Excelsior Springs, MO 64024-3518 - Phone
- (816) 615-9030
- NPI assigned
- Apr 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 02139 | MO | Primary |
Addresses
Primary practice location
940 Holly St
Excelsior Springs, MO 64024-3518
Mailing address
2600 Compass Rd
Glenview, IL 60026-8001
Phone (877) 787-3430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02139 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1871055004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 COMPASS RD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268001",
"telephone_number": "877-787-3430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 HOLLY ST",
"city": "EXCELSIOR SPRINGS",
"state": "MO",
"postal_code": "640243518",
"telephone_number": "816-615-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNA",
"first_name": "KIMBERLY",
"middle_name": "RENEE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-05",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "02139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Excelsior Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.