Physical Therapy Clinic of Ava, P.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

R0933 Issued in MO

Legal business name

PHYSICAL THERAPY CLINIC OF AVA, P.C.

Practice address

1307 Haden Street
Ava, MO 65608-5105

Phone

(417) 683-3380

Fax

(417) 683-3386

NPI assigned

May 25, 2010

Last updated

Feb 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mylene S. Baguio, R.P.T.NPI 1306059977

Title

Secretary / 50 Owner

Phone

(417) 683-3380

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mylene Baguio, RPT

  • Physical Therapist
  • Ava, MO
  • NPI 1306059977
  NPD Authorized official

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1023337391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 HADEN STREET",
            "city": "AVA",
            "state": "MO",
            "postal_code": "656085105",
            "telephone_number": "417-683-3380",
            "fax_number": "417-683-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 HADEN STREET",
            "city": "AVA",
            "state": "MO",
            "postal_code": "656085105",
            "telephone_number": "417-683-3380",
            "fax_number": "417-683-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CLINIC OF AVA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "BAGUIO",
        "authorized_official_first_name": "MYLENE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "SECRETARY / 50 OWNER",
        "authorized_official_telephone_number": "417-683-3380",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "R0891",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "R0933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756697306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Ava, MO
• Providers in Ava, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.