Provider Demographics
NPI:1073565149
Name:HELMER, CHAD E (PT)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:E
Last Name:HELMER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17134 BEL RAY PL
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-5331
Mailing Address - Country:US
Mailing Address - Phone:816-226-4011
Mailing Address - Fax:816-524-6115
Practice Address - Street 1:1512 NE 96TH ST
Practice Address - Street 2:STE A
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-7174
Practice Address - Country:US
Practice Address - Phone:816-792-0775
Practice Address - Fax:816-792-0776
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4370012OtherMEDICARE PTAN
26735101OtherBCBS KC