Proactive Physical Therapy and Sports Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROACTIVE PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC

Practice address

623 S Washington Street
Chillicothe, MO 64601

Phone

(660) 973-7364

NPI assigned

Jun 5, 2024

Last updated

Jun 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clinton Eric Singleton, DPTNPI 1720439599

Title

Owner, Doctor of Physical Therapy

Phone

(660) 973-7364

Specialties & licenses 1

Addresses

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, and the practitioner matching its NPPES authorized official.

• Clinton Eric Singleton, PT, DPT

  • Physical Therapist
  • Kearney, MO
  • NPI 1720439599
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1083455638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 SOUTH WASHINGTON STREET",
            "address_2": "PO BOX 115",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "64601",
            "telephone_number": "660-973-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S WASHINGTON STREET",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "64601",
            "telephone_number": "660-973-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-01",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER, DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "660-973-7364",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Susanne Pickering, LCSW
• Angela R Poling, PSYCHOLOGIST
• Jennifer Powell, PHARMD
• Preferred Family Healthcare, Inc.
• Brooke J. D. Preylo, PSYD
• Eleanor Ravens, MA, CCC-SLP
• Danelle Reagin, MSN, FNP
• Kimberly Marie Rice
• Marilise Rogers, DDS
• Saint Lukes Hospital of Chillicothe (Hedrick Medical Center)

• Physical Therapy Clinic/Center in Chillicothe, MO
• Providers in Chillicothe, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.