Healthcare Provider Details

I. General information

NPI: 1316877384
Provider Name (Legal Business Name): PATRICK PINKINS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 NW JEFFERSON ST
BLUE SPRINGS MO
64015-7229
US

IV. Provider business mailing address

4611 S EASTLAND CENTER DR APT 613
INDEPENDENCE MO
64055-7806
US

V. Phone/Fax

Practice location:
  • Phone: 816-296-9879
  • Fax:
Mailing address:
  • Phone: 816-521-1699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: