Individual provider Active NPI

Ann Heath Pietroburgo, OTR CHT

  • Hand Occupational Therapist
  • St Louis, MO
National Provider Identifier
1003926130
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
004321 Issued in MO
Practice address
4600 Chippewa
Ste F
St Louis, MO 63116
Phone
(314) 351-7172
Fax
(314) 351-6885
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 004321 MO Primary

Addresses

Primary practice location

4600 Chippewa
Ste F
St Louis, MO 63116

Mailing address

615 Nirk Ave
Kirkwood, MO 63122
Phone (314) 965-2136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050526000113 MO Practitioner - Occupational Therapist in Private Practice 5799727046 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004321MOMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC CurrentSince Jan 4, 2021 Accepting new patients
Axes Physical Therapy, LLC CurrentSince Jan 4, 2021 Accepting new patients
Prorehab PC Hand Past Accepting new patients
Prorehab, PC Past Accepting new patients

Locations

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

8015 Mackenzie Rd
Saint Louis, MO 63123
Phone (314) 356-2442

4131 Union Rd
Saint Louis, MO 63129
Phone (314) 274-9222

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

Interoperability endpoints

  • Direct secure messaging: annie.pietroburgo.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003926130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 NIRK AVE",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "63122",
            "telephone_number": "314-965-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 CHIPPEWA",
            "address_2": "STE F",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63116",
            "telephone_number": "314-351-7172",
            "fax_number": "314-351-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETROBURGO",
        "first_name": "ANN",
        "middle_name": "HEATH",
        "name_prefix": "Ms.",
        "credential": "OTR CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MO",
            "license": "004321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.