Provider Demographics
NPI:1982654000
Name:HINES, WENDI L (MPT)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:L
Last Name:HINES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:L
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
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 1:7932 N OAK TRFY
Practice Address - Street 2:SUITE 212
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-1423
Practice Address - Country:US
Practice Address - Phone:816-420-0286
Practice Address - Fax:816-420-8207
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999139193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
28350139OtherBCBS KC
MOMA4370002OtherMEDICARE PTAN
MOL10C701Medicare PIN
MOW12000004Medicare PIN