NPIMap

Organization Active NPI

Lifevision, Inc.

Doing business as Physical Therapy Innovations

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1053449579
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00923 Issued in MO
Legal business name
LIFEVISION, INC.
Doing business as
Physical Therapy Innovations
Practice address
338 S Kirkwood Rd
Unit 104B
Saint Louis, MO 63122-6166
Phone
(314) 984-0068
Fax
(314) 984-0338
NPI assigned
Feb 28, 2007
Last updated
Jul 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Ms. Mary Ellen Openlander, P.T.NPI 1609060938
Title
Vice President
Phone
(314) 984-0068

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 00923 MO Primary

Addresses

Primary practice location

338 S Kirkwood Rd
Unit 104B
Saint Louis, MO 63122-6166

Mailing address

338 S Kirkwood Rd
Unit 104B
Saint Louis, MO 63122-6166
Phone (314) 984-0068

Other names 1

  • Physical Therapy Innovations Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070710000282 MO Part B Supplier - Clinic/Group Practice 6507966330 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

338 S Kirkwood Rd
Ste 104B
Saint Louis, MO 63122
Phone (314) 984-0068

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1053449579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 S KIRKWOOD RD",
            "address_2": "UNIT 104B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226166",
            "telephone_number": "314-984-0068",
            "fax_number": "314-984-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 S KIRKWOOD RD",
            "address_2": "UNIT 104B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226166",
            "telephone_number": "314-984-0068",
            "fax_number": "314-984-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEVISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "OPENLANDER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "314-984-0068",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "00923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy Innovations",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.

Verify at the official NPI Registry.