Individual provider Active NPI

Emily M Cichon, PT, DPT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1053980847
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2021033727 Issued in MO
Practice address
9326 Olive Blvd Ste 100
Saint Louis, MO 63132-3257
Phone
(314) 784-9646
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2021033727 MO Primary

Addresses

Primary practice location

9326 Olive Blvd Ste 100
Saint Louis, MO 63132-3257

Mailing address

14515 North Outer 40 Rd Ste 110
Chesterfield, MO 63017-5746
Phone (314) 434-8086

Other names 1

  • Emily M Thibon Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005001934 MO Practitioner - Physical Therapist in Private Practice 1658779624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atr Chris LLCGroup PAC ID 4183019003, 4 clinicians

Practice addresses (Care Compare)

9326 Olive Blvd
Suite 100
Olivette, MO 63132-3257
Phone (314) 784-9646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021033727MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atr Chris LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 18, 2021 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 18, 2021 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

2937 S Brentwood Blvd
Saint Louis, MO 63144
Phone (314) 961-3804

9326 Olive Blvd
Ste 100
Saint Louis, MO 63132
Phone (314) 784-9646

14515 North Outer 40 Rd
Ste 110
Town and Country, MO 63017
Phone (314) 434-6060

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: emily.thibon.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1053980847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14515 NORTH OUTER 40 RD STE 110",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175746",
            "telephone_number": "314-434-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9326 OLIVE BLVD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323257",
            "telephone_number": "314-784-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICHON",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021033727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "THIBON",
            "middle_name": "M",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.