Active NPI
Brian J Rose, PT
- Physical Therapist
- Saint Louis, MO
National Provider Identifier
1023029113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 114203
- Practice address
- 4850 Lemay Ferry Rd
Suite 120
Saint Louis, MO 63129-1576 - Phone
- (314) 416-1707
- Fax
- (314) 416-7184
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 114203 | MO | Primary |
Addresses
Primary practice location
4850 Lemay Ferry Rd
Suite 120
Saint Louis, MO 63129-1576
Mailing address
4850 Lemay Ferry Rd
Suite 101
Saint Louis, MO 63129-1576
Phone (314) 416-0439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114203 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Rehabilitation Hospital - St Louis, LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Hospital
- Chesterfield, MO
- NPI 1811048614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023029113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4850 LEMAY FERRY RD",
"address_2": "SUITE 101",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631291576",
"telephone_number": "314-416-0439",
"fax_number": "314-416-7626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4850 LEMAY FERRY RD",
"address_2": "SUITE 120",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631291576",
"telephone_number": "314-416-1707",
"fax_number": "314-416-7184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "BRIAN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "114203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.