NPIMap

Organization Active NPI

Prorehab PC

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1053820175
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROREHAB PC
Practice address
11525 Olde Cabin Rd Ste 1
Saint Louis, MO 63141-7146
Phone
(636) 239-9979
Fax
(636) 239-5442
NPI assigned
Sep 20, 2017
Last updated
Sep 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Authorized official

Name
Geri Cook
Title
VP of Billing Operations
Phone
(630) 575-1940

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

11525 Olde Cabin Rd Ste 1
Saint Louis, MO 63141-7146

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813

National Provider Directory

National Provider Directory
Tax ID family
Prorehab PC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1053820175",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 OLDE CABIN RD STE 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417146",
            "telephone_number": "636-239-9979",
            "fax_number": "636-239-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "GERI",
        "authorized_official_title_or_position": "VP OF BILLING OPERATIONS",
        "authorized_official_telephone_number": "630-575-1940"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 20, 2017; 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.