Individual provider Active NPI

Jacqueline D Schranck, DPT

  • Physical Therapist
  • Brentwood, MO
National Provider Identifier
1124377221
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2012027769 Issued in MO
Practice address
2937 S Brentwood Blvd
Suite 105
Brentwood, MO 63144-2713
Phone
(314) 961-3804
Fax
(314) 961-1147
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.019678 IL
Physical Therapist 225100000X 2012027769 MO Primary

Addresses

Primary practice location

2937 S Brentwood Blvd
Suite 105
Brentwood, MO 63144-2713

Mailing address

600 Oakmont LN
Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-1980

Other names 1

  • Jacqueline D Spies Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121116000431 MO Practitioner - Physical Therapist in Private Practice 8426209628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
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)

1832 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone (636) 327-7110

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

229 S Stewart Rd
Suite E 3
Liberty, MO 64068-4206
Phone (816) 656-3695

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.019678ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 24, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 24, 2020 Accepting new patients

Locations

1047 Century Dr
Edwardsville, IL 62025
Phone (618) 307-3434

1355 Maple St
Farmington, MO 63640
Phone (573) 756-9900

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

951 Waterbury Falls Dr
O Fallon, MO 63368
Phone (636) 336-0300

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

107 Concord Plaza Shopping Ctr
Saint Louis, MO 63128
Phone (314) 842-2990

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

Interoperability endpoints

  • Direct secure messaging: jacqueline.schranck.p2@direct.athleticoltd.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1124377221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN",
            "address_2": "STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 S BRENTWOOD BLVD",
            "address_2": "SUITE 105",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442713",
            "telephone_number": "314-961-3804",
            "fax_number": "314-961-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRANCK",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.019678",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012027769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "SPIES",
            "middle_name": "D",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brentwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.