Individual provider Active NPI

Andrea Adam, MPT

  • Physical Therapist
  • Chesterfield, MO
National Provider Identifier
1114966710
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2005019707 Issued in MO
Practice address
17300 N Outer 40
Suite 205
Chesterfield, MO 63005-1361
Phone
(636) 728-1777
NPI assigned
Jun 6, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 2005019707 MO Primary

Addresses

Primary practice location

17300 N Outer 40
Suite 205
Chesterfield, MO 63005-1361

Mailing address

17300 N Outer 40
Suite 205
Chesterfield, MO 63005-1361
Phone (636) 728-1777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070322000240 MO Practitioner - Physical Therapist in Private Practice 4082718598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy DirectGroup PAC ID 9638583313, 2 clinicians

Practice addresses (Care Compare)

Saint Charles, MO 63304
Phone (314) 328-5553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005019707MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Direct Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Imove Telept, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114966710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 N OUTER 40",
            "address_2": "SUITE 205",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051361",
            "telephone_number": "636-728-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 N OUTER 40",
            "address_2": "SUITE 205",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051361",
            "telephone_number": "636-728-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAM",
        "first_name": "ANDREA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2005019707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.