Prorehab PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROREHAB PC

Practice address

6309 Ronald Reagan Dr
Lake St Louis, MO 63367-2681

Phone

(636) 755-4566

Fax

(636) 561-0242

NPI assigned

Jun 27, 2016

Organization subpart

No

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

Authorized official

Name

Geri Cook

Title

Director of Clinical Services

Phone

(630) 575-1940

Specialties & licenses 1

Addresses

Other names 1

• ATHLETICO PHYSICAL THERAPY Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1427264233

  Member Of

  NPD member

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1043661465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 RONALD REAGAN DR",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672681",
            "telephone_number": "636-755-4566",
            "fax_number": "636-561-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "GERI",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "630-575-1940"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATHLETICO PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patt Hollinger Pickett, PHD
• Alexandra Piwowarczyk, MSW, LCSW
• David L Pohl, M.D.
• Hannah Poteet
• Victoria S Powell, LPC
• Kamran Qureshi, MD
• Gina T Randolph
• Prityi Rani, MD
• Amy Ratican, LPC
• Sarah Ann Ray, M.S., CCC-SLP

• Physical Therapist in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.