Active NPI
Maureen Julia Mitchell, RPT
- Pediatric Physical Therapist
- Overland Park, KS
National Provider Identifier
1912021338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1101270
- Practice address
- 7620 Metcalf Avenue
Suite M
Overland Park, KS 66204-2996 - Phone
- (913) 383-9014
- Fax
- (913) 383-9015
- NPI assigned
- Mar 19, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1101270 | KS | Primary |
Addresses
Primary practice location
7620 Metcalf Avenue
Suite M
Overland Park, KS 66204-2996
Mailing address
7620 Metcalf Avenue
Suite M
Overland Park, KS 66204-2996
Phone (913) 383-9014
Other names 1
- Ms. Maureen Julia Kennally
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 |
|---|---|---|---|
| 1101270 | KS | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Therapy Group Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912021338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7620 METCALF AVENUE",
"address_2": "SUITE M",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662042996",
"telephone_number": "913-383-9014",
"fax_number": "913-383-9015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7620 METCALF AVENUE",
"address_2": "SUITE M",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662042996",
"telephone_number": "913-383-9014",
"fax_number": "913-383-9015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "MAUREEN",
"middle_name": "JULIA",
"name_prefix": "Ms.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "KS",
"license": "1101270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MAUREEN",
"last_name": "KENNALLY",
"middle_name": "JULIA",
"prefix": "MS.",
"credential": "RPT",
"code": "1",
"type": "Former Name"
}
]
}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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.