Individual provider Active NPI

Jennifer Lynn Mattson, MPT

  • Physical Therapist
  • Lees Summit, MO
National Provider Identifier
1972707461
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2006023029 Issued in MO
Practice address
401 NW Murray Rd
Lees Summit, MO 64081-1425
Phone
(816) 944-4244
Fax
(913) 745-4352
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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 2006023029 MO Primary

Addresses

Primary practice location

401 NW Murray Rd
Lees Summit, MO 64081-1425

Mailing address

22120 Midland Dr Ste 1
Shawnee, KS 66226-3554
Phone (913) 745-4064

Other names 1

  • Ms. Jennifer Lynn Boulton Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000400 MO Practitioner - Physical Therapist in Private Practice 8426157645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Fit Muscle and Joint Clinic LLCGroup PAC ID 5991935579, 54 clinicians

Practice addresses (Care Compare)

401 NW Murray Rd
Lees Summit, MO 64081-1425
Phone (816) 944-4244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006023029MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fit Muscle & Joint Clinic LLC Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Fit Muscle & Joint Clinic LLC Physical Therapist Past Accepting new patients

Locations

401 NW Murray Rd
Lees Summit, MO 64081
Phone (816) 944-4244

Organizations & group practices 3

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1972707461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22120 MIDLAND DR STE 1",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263554",
            "telephone_number": "913-745-4064",
            "fax_number": "913-745-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NW MURRAY RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640811425",
            "telephone_number": "816-944-4244",
            "fax_number": "913-745-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006023029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOULTON",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.