Re Active Training & Rehab LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RE ACTIVE TRAINING & REHAB LLC

Practice address

1401 Gettysburg LNDG
Saint Charles, MO 63303-6104

Phone

(636) 443-9910

Fax

(636) 200-3601

NPI assigned

Sep 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Lynn Bray, DPT

Title

Administrator

Phone

(636) 443-9910

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1023788767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GETTYSBURG LNDG",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036178",
            "telephone_number": "636-443-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GETTYSBURG LNDG",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036104",
            "telephone_number": "636-443-9910",
            "fax_number": "636-200-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RE ACTIVE TRAINING & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "636-443-9910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mail.google.com/mail/u/0/#inbox",
            "affiliation": "N",
            "endpointDescription": "Administration Communication",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1401 Gettysburg Lndg",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633036104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Saint Charles, MO
• Providers in Saint Charles, 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 Jun 12, 2026; 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.