Individual provider Active NPI

Amelia Helen Bottcher

  • Physical Therapist
  • Ballwin, MO
National Provider Identifier
1104654433
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2200 Barrett Station Rd Ste 200
Ballwin, MO 63021-5893
Phone
(314) 238-1130
NPI assigned
Jul 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 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 Primary

Addresses

Primary practice location

2200 Barrett Station Rd Ste 200
Ballwin, MO 63021-5893

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913000161 MO Practitioner - Physical Therapist in Private Practice 0244770527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

2200 Barrett Station Rd
Suite 200
Ballwin, MO 63021-5893
Phone (314) 238-1130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 29, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 29, 2024 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients

Locations

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

2200 Barrett Station Rd
#200
Ballwin, MO 63021
Phone (314) 238-1130

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

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

Interoperability endpoints

  • Direct secure messaging: amelia.bottcher.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1104654433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BARRETT STATION RD STE 200",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215893",
            "telephone_number": "314-238-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTCHER",
        "first_name": "AMELIA",
        "middle_name": "HELEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.