Provider Demographics
NPI:1831175710
Name:KINNEY, ALISON MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIE
Last Name:KINNEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MARIE
Other - Last Name:DEICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:17134 BEL RAY PL
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-5331
Practice Address - Country:US
Practice Address - Phone:816-318-0436
Practice Address - Fax:816-318-0437
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03349225100000X
MO2011000805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
45115101OtherBCBS KC
MOMA4370027OtherMEDICARE PTAN
KSKA2868016OtherMEDICARE PTAN
KS45115031OtherBCBS KC
MOMA2104008Medicare PIN
MOT29000010Medicare PIN
MOK86000016Medicare PIN
MO45115041OtherBCBS KC
MO45115061OtherBCBS OF KC
MOK86B00016Medicare PIN
MOT07000011Medicare PIN