NPIMap

Organization Active NPI

Axes Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Glen Carbon, IL
National Provider Identifier
1093425944
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
AXES PHYSICAL THERAPY, LLC
Practice address
138 Junction Dr
Glen Carbon, IL 62034-4322
Phone
(618) 636-5756
NPI assigned
Dec 1, 2022
Last updated
Dec 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
John Teepe
Title
Member
Phone
(314) 764-2230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

138 Junction Dr
Glen Carbon, IL 62034-4322

Mailing address

4273 Keaton Crossing Blvd
O Fallon, MO 63368-8220
Phone (636) 206-6540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230510000266 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375840028 Receives reassigned benefits from 8 practitioners
Practice locations: Glen Carbon, IL

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Axes Physical Therapy LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1093425944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 KEATON CROSSING BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688220",
            "telephone_number": "636-206-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 JUNCTION DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620344322",
            "telephone_number": "618-636-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXES PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "TEEPE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-764-2230"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.