Physical Medicine Group, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2006038287 Issued in MO

Legal business name

PHYSICAL MEDICINE GROUP, LLC

Practice address

8633 Mexico Rd
O Fallon, MO 63366-7506

Phone

(636) 272-8888

Fax

(636) 272-7385

NPI assigned

Mar 14, 2012

Last updated

Jun 5, 2012By 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

Michael Williams

Title

President

Phone

63627288888

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1033484795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8633 MEXICO RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8633 MEXICO RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667506",
            "telephone_number": "636-272-8888",
            "fax_number": "636-272-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "63627288888"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2006038287",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2006038287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Peter, NP
• Dawn C Peters
• Mary Kathryn Peters, OTA/L
• Jennifer Marie Phillips, APRN-C
• Alyssa A Phinney
• Physician Groups LC (Carson Agee MD)
• Physician Groups LC (Internal Medicine Associates)
• Physician Groups LC (Progress West Orthopaedics)
• Physician Groups LC (Pheasant Point Physicians)
• Physician Groups LC (Contemporary Women's Healthcare)

• Anesthesiology Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.