Active NPI
Sara M Lester, MPT
- Orthopedic Physical Therapist
- O Fallon, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2004009617
- Practice address
- 916 Talon Dr
Suite 102
O Fallon, IL 62269-1848 - Phone
- (618) 628-8211
- Fax
- (618) 628-0883
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2004009617 | MO | Primary |
Addresses
Primary practice location
916 Talon Dr
Suite 102
O Fallon, IL 62269-1848
Mailing address
916 Talon Drive
Suite 102
Ofallon, IL 62269-1468
Phone (618) 628-8211
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 900068033 | Other | IL | TAX-ID |
| 08220357 | Other | IL | BCBS GRP# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Saint Louis University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5701 Godfrey Rd
Godfrey, IL 62035-2471
Phone (618) 433-9919
634 N Market St
Waterloo, IL 62298-1012
Phone (618) 939-3400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004009617 | MO | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Physical Therapy Services,LLC | Orthopedic | Current | Accepting new patients |
Locations
5701 Godfrey Rd
Godfrey, IL 62035
Phone (618) 433-9919
15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482
634 N Market St
Waterloo, IL 62298
Phone (618) 939-3400
917 N Illinois Route 3
Waterloo, IL 62298
Phone (618) 939-3400
Organizations & group practices 1
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": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397174400000",
"number": "1144330697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 TALON DRIVE",
"address_2": "SUITE 102",
"city": "OFALLON",
"state": "IL",
"postal_code": "622691468",
"telephone_number": "618-628-8211",
"fax_number": "618-628-0883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 TALON DR",
"address_2": "SUITE 102",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691848",
"telephone_number": "618-628-8211",
"fax_number": "618-628-0883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESTER",
"first_name": "SARA",
"middle_name": "M",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2014-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MO",
"license": "2004009617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX-ID",
"identifier": "900068033",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GRP#",
"identifier": "08220357",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.