OrganizationActive
Element Physical Medicine, LLC
NPI 1205120649 · Physical Medicine & Rehabilitation Physician · Kansas City, MO
Provider details
- NPI number
- 1205120649
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelly Logan, Owner(816) 924-9475
- License
- 2010035953 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
601 E. 63rd Street
Suite 210
Kansas City, MO 64110-3303
Phone: (816) 924-9475
Street-level locationGet directions
Mailing address
Po Box 16861
Raytown, MO 64133-9998
Registry dates
- Enumerated
- 2011-06-02
- Last updated
- 2016-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.