Active NPI
Dynamic Strides Therapy Inc
- Physical Therapist
- Republic, MO
National Provider Identifier
1104378561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- DYNAMIC STRIDES THERAPY INC
- Practice address
- 2673 E Sawyer Rd
Republic, MO 65738-7574 - Phone
- (479) 422-1183
- Fax
- (479) 202-8282
- NPI assigned
- Nov 1, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leah Copeland
- Title
- Credentialing
- Phone
- (479) 202-8282
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
2673 E Sawyer Rd
Republic, MO 65738-7574
Mailing address
2673 E Sawyer Rd
Republic, MO 65738-7574
Phone (479) 422-1183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180301000460 | MO | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5395006662 |
Receives reassigned benefits from 3 practitioners Practice locations: Republic, MO |
National Provider Directory
National Provider DirectoryLocations
2673 E Sawyer Rd
Republic, MO 65738
Phone (417) 324-7646
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapy Assistant
- Republic, MO
- NPI 1013788330
-
- Physical Therapy Assistant
- Republic, MO
- NPI 1376304428
-
- Occupational Therapist
- Republic, MO
- NPI 1841571809
-
- Occupational Therapist
- Cedar Rapids, IA
- NPI 1992533681
-
- Speech-Language Pathologist
- Springfield, MO
- NPI 1902054208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719792000000",
"number": "1104378561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2673 E SAWYER RD",
"city": "REPUBLIC",
"state": "MO",
"postal_code": "657387574",
"telephone_number": "479-422-1183",
"fax_number": "479-202-8282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2673 E SAWYER RD",
"city": "REPUBLIC",
"state": "MO",
"postal_code": "657387574",
"telephone_number": "479-422-1183",
"fax_number": "479-202-8282"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNAMIC STRIDES THERAPY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-01",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A",
"authorized_official_last_name": "COPELAND",
"authorized_official_first_name": "LEAH",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "479-202-8282"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Republic, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.