Individual provider Active NPI

Richard Charles Kidwell, DPT

  • Physical Therapist
  • Overland Park, KS
National Provider Identifier
1902151087
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-03851 Issued in KS
Practice address
6400 Glenwood St
111
Overland Park, KS 66202-4028
Phone
(913) 831-2721
Fax
(913) 384-0127
NPI assigned
Jul 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-03851 KS Primary

Addresses

Primary practice location

6400 Glenwood St
111
Overland Park, KS 66202-4028

Mailing address

6400 Glenwood St
111
Overland Park, KS 66202-4028
Phone (913) 831-2721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140617001473 MO Practitioner - Physical Therapist in Private Practice 4284858036 Reassigns benefits to 1 organization
I20140624002316 KS Practitioner - Physical Therapist in Private Practice 4284858036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arc Physical Therapy Plus LPGroup PAC ID 6204050453, 59 clinicians

Practice addresses (Care Compare)

1174 NE Douglas St
Lees Summit, MO 64086-4602
Phone (816) 875-3884

139 N Belt Hwy
Suite N
Saint Joseph, MO 64506-3445
Phone (816) 231-1137

15455 S Rogers Rd
Olathe, KS 66062-3497
Phone (913) 254-0568

1711 W Battlefield St
Suite Q
Springfield, MO 65807-4183
Phone (417) 799-3377

1931 Burlington St
N Kansas City, MO 64116-3407
Phone (816) 241-2131

2000 Kentucky Ave
Suite D
Platte City, MO 64079-7714
Phone (816) 858-2368

505 NE Adams Dairy Pkwy
Suite a
Blue Springs, MO 64014-5488
Phone (816) 988-2800

527 N State Route 291
Suite a
Liberty, MO 64068-1045
Phone (816) 792-0849

5404 NE Antioch Rd
Arc Gladstone
Kansas City, MO 64119-2507
Phone (816) 454-5818

609 E Platte Clay Way B
Arc Cameron
Cameron, MO 64429-8879
Phone (816) 632-3221

6505 E 37TH St N
Suite 300
Wichita, KS 67226-3233
Phone (316) 854-2330

655 W State Route 92 B
Arc Kearney
Kearney, MO 64060-8661
Phone (816) 551-2030

662 E 47TH St S
Arc Wichita South
Wichita, KS 67216-1769
Phone (316) 252-2888

6803 W Taft BLDG
300 Suite 303
Wichita, KS 67209-2365
Phone (316) 347-7969

8200 Southport Dr
Suite 106a
Manhattan, KS 66502-8142
Phone (758) 789-5015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-03851KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arc Physical Therapy Plus LP CurrentSince Jun 1, 2014 Accepting new patients
Arc Physical Therapy Plus LP Physical Therapist CurrentSince Jun 1, 2014 Accepting new patients

Locations

15455 S Rogers Rd
Olathe, KS 66062
Phone (913) 254-0568

6400 Glenwood St
Ste 111
Overland Park, KS 66202
Phone (877) 344-2721

609 E Platte Clay Way
Ste B
Cameron, MO 64429
Phone (816) 632-3221

527 N State Route 291
Ste A
Liberty, MO 64068
Phone (816) 792-0849

1711 W Battlefield St
Ste Q
Springfield, MO 65807
Phone (417) 799-3377

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1902151087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 GLENWOOD ST",
            "address_2": "111",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662024028",
            "telephone_number": "913-831-2721",
            "fax_number": "913-384-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 GLENWOOD ST",
            "address_2": "111",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662024028",
            "telephone_number": "913-831-2721",
            "fax_number": "913-384-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "RICHARD",
        "middle_name": "CHARLES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.