Organization Active NPI

KMGP Holdings LLC

Doing business as Feeding Friends Therapy Services

  • Speech-Language Pathologist
  • Saint Peters, MO
National Provider Identifier
1952069841
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
KMGP HOLDINGS LLC
Doing business as
Feeding Friends Therapy Services
Practice address
1400 Triad Center Dr Ste a
Saint Peters, MO 63376-7351
Phone
(314) 254-2188
Fax
(833) 638-0807
NPI assigned
Dec 7, 2021
Last updated
Feb 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Attea Costanzo, MS CCC-SLPNPI 1861846305
Title
Owner Speech Therapist
Phone
(915) 603-7070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

1400 Triad Center Dr Ste a
Saint Peters, MO 63376-7351

Mailing address

901 Tenlynn CT
Saint Louis, MO 63124-1250
Phone (915) 603-7070

Other practice location 1

901 Tenlynn Ct
Saint Louis, MO 63124-1250
Phone (915) 603-7070

Other names 1

  • Feeding Friends Therapy Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Support@myfeedingfriends.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220328000180 MO Part B Supplier - Clinic/Group Practice 5193110203 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

1400 Triad Center Dr
Ste A
Saint Peters, MO 63376
Phone (314) 254-2188

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1952069841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 TENLYNN CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241250",
            "telephone_number": "915-603-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TRIAD CENTER DR STE A",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767351",
            "telephone_number": "314-254-2188",
            "fax_number": "833-638-0807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Tenlynn Ct",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631241250",
            "country_code": "US",
            "telephone_number": "915-603-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KMGP HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "COSTANZO",
        "authorized_official_first_name": "ATTEA",
        "authorized_official_title_or_position": "OWNER SPEECH THERAPIST",
        "authorized_official_telephone_number": "915-603-7070",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Support@myfeedingfriends.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "901 Tenlynn Ct",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631241250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Feeding Friends Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Feeding Friends Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.