Active NPI
Stephanie R Foster, PT
- Physical Therapist
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 900 Main St Ste 450
Peoria, IL 61602-5018 - Phone
- (309) 672-4568
- NPI assigned
- Jan 18, 2012
- 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 | Primary |
Addresses
Primary practice location
900 Main St Ste 450
Peoria, IL 61602-5018
Mailing address
2900 Frank Scott Pkwy W Ste 928
Belleville, IL 62223-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01103818 | Other | IL | RR MEDICARE |
Other names 1
- Stephanie R Booth
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Therapy Services, Inc | Physical Therapist | Current | Accepting new patients |
Locations
2900 Frank Scott Pkwy W
Ste 930
Belleville, IL 62223
Phone (618) 222-9383
1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124
2338 W Van Winkle Way
Ste 3100
Peoria, IL 61615
Phone (309) 693-9189
900 Main St
Ste 450
Peoria, IL 61602
Phone (309) 672-4568
209 N Cummings Ln
Washington, IL 61571
Phone (309) 643-6185
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.
-
- Physical Therapist
- Pekin, IL
- NPI 1578615225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644192000000",
"number": "1033480355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 FRANK SCOTT PKWY W STE 928",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MAIN ST STE 450",
"city": "PEORIA",
"state": "IL",
"postal_code": "616025018",
"telephone_number": "309-672-4568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSTER",
"first_name": "STEPHANIE",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01103818",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "BOOTH",
"middle_name": "R",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.