Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Tarah Judith An Phongsavath, DPT

Individual provider Physical Therapist · NPI 1780422006

Dr. Tarah Judith An Phongsavath, DPT is a Physical Therapist in Private Practice in Kansas City, Missouri. Qualified in 2024, 2 years ago. Practices with Foundational Concepts Inc, a 16-clinician group. Licensed in Kansas.

Years since qualifying
2
Licensed in
KS
In the registry since
2024
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

601 E 63rd St
Kansas City, MO 64110-3303
Phone: (816) 569-2802
Fax: (816) 569-5436
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11-07644 (KS)

Record details

NPI number1780422006
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedJuly 19, 2024
Last updated in NPPESAugust 13, 2024
Certification dateAugust 6, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Foundational Concepts Inc — 16 clinicians
Accepts Medicare assignment Not indicated

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