Individual provider Active NPI

Diana Annette Aubuchon, PTA

  • Physical Therapy Assistant
  • Clayton, MO
National Provider Identifier
1144492885
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
115653 Issued in MO
Practice address
7733 Forsyth Blvd
Suite 2300
Clayton, MO 63105-1817
Phone
(800) 482-3001
NPI assigned
Apr 1, 2008
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 115653 MO
Physical Therapy Assistant 225200000X 115653 MO Primary

Addresses

Primary practice location

7733 Forsyth Blvd
Suite 2300
Clayton, MO 63105-1817

Mailing address

2842 Dardenne Links Dr
Dardenne Prairie, MO 63368-9741
Phone (636) 544-3212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
115653MOMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1144492885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2842 DARDENNE LINKS DR",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633689741",
            "telephone_number": "636-544-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 FORSYTH BLVD",
            "address_2": "SUITE 2300",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051817",
            "telephone_number": "800-482-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUBUCHON",
        "first_name": "DIANA",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "115653",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "115653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.