Provider Demographics
NPI:1841392123
Name:FOLEY, HEATHER GOIST (RPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GOIST
Last Name:FOLEY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:G
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPT
Mailing Address - Street 1:3215 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2645
Mailing Address - Country:US
Mailing Address - Phone:816-472-1800
Mailing Address - Fax:
Practice Address - Street 1:3215 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1946
Practice Address - Country:US
Practice Address - Phone:816-472-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-021892251S0007X
MO109154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100211030AMedicaid
650010779OtherRAILROAD MEDICARE
KS635250OtherKANSAS FIRSTGUARD
MO22783028OtherBCBS KC
MO488637000Medicaid
KS100211030AMedicaid
J729075Medicare ID - Type UnspecifiedMEDICARE NUMBER