CVPT-St. Charles, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2010025564 Issued in MO

Legal business name

CVPT-ST. CHARLES, LLC

Practice address

4075 N Saint Peters Pkwy
Saint Peters, MO 63304-7396

Phone

(636) 728-1777

NPI assigned

Nov 25, 2015

Organization subpart

No

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

Authorized official

Name

Michael J Gorman, PHD, PT, DMT, FAAOMP

Title

Owner

Phone

(636) 728-1777

Specialties & licenses 1

Addresses

Other names 1

• St. Louis Physical Therapy Doing business as

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1043684202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 NORTH OUTER 40 RD",
            "address_2": "SUITE 202",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051375",
            "telephone_number": "636-728-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 N SAINT PETERS PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633047396",
            "telephone_number": "636-728-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVPT-ST. CHARLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-728-1777",
        "authorized_official_credential": "PHD, PT, DMT, FAAOMP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2010025564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Louis Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antionette Cummings
• Kristen Mary Cummings, D.M.D.
• Latasha L Cunningham, NP
• Robert B Cusworth, MD
• Valerie Dee Cutright, RPH
• D & a Medical Equipment
• D & M Companions Home Healthcare
• Daniel Michael D'Addio, DDS
• William Charles Dale III, D.M.D.
• Lea Marie Damrell, OTR/L

• Physical Therapist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.