Active NPI
Kristen Pierce
- Physical Therapy Assistant
- Creve Coeur, MO
National Provider Identifier
1053041855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2017024964
- Practice address
- 11630 Studt Ave Ste 200
Creve Coeur, MO 63141-7394 - Phone
- (636) 244-8248
- NPI assigned
- Jun 14, 2022
- Last updated
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 2017024964 | MO | Primary |
Addresses
Primary practice location
11630 Studt Ave Ste 200
Creve Coeur, MO 63141-7394
Mailing address
909 Selma Ave
Webster Groves, MO 63119-4763
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017024964 | Other | MO | PHYSICAL THERAPIST ASSISTANT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017024964 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1053041855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 SELMA AVE",
"city": "WEBSTER GROVES",
"state": "MO",
"postal_code": "631194763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11630 STUDT AVE STE 200",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417394",
"telephone_number": "636-244-8248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERCE",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2017024964",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST ASSISTANT",
"identifier": "2017024964",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.