Lifevision, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

00923 Issued in MO

Legal business name

LIFEVISION, INC.

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

Organization subpart

No

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.

Title

Vice President

Phone

(314) 984-0068

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Physical Therapy Innovations Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick J. Openlander, PH.D.

  • Psychologist
  • Kirkwood, MO
  • NPI 1558425801
  Medicare reassignment

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "115373",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "5769225",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROVIDE",
            "identifier": "64-01386",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy Innovations",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Corinne Laura Lige, B.C.O.

• Physical Therapist in Saint Louis, MO
• Providers in Saint 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 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.