Active NPI
Gregory Wayne Rubel, PT
- Physical Therapist
- Bridgeton, MO
National Provider Identifier
1144539354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 113788
- Practice address
- 12115 Bridgeton SQ
Bridgeton, MO 63044-2616 - Phone
- (314) 291-8380
- Fax
- (314) 291-7356
- NPI assigned
- Oct 5, 2010
- Last updated
- Oct 5, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 113788 | MO | Primary |
Addresses
Primary practice location
12115 Bridgeton SQ
Bridgeton, MO 63044-2616
Mailing address
12115 Bridgeton SQ
Bridgeton, MO 63044-2616
Phone (314) 291-8380
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113788 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Past | Accepting new patients |
Interoperability endpoints
- gregory.rubel.p2@direct.athleticoltd.nextgenshare.com
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, 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": "1286236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1144539354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12115 BRIDGETON SQ",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442616",
"telephone_number": "314-291-8380",
"fax_number": "314-291-7356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12115 BRIDGETON SQ",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442616",
"telephone_number": "314-291-8380",
"fax_number": "314-291-7356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBEL",
"first_name": "GREGORY",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-05",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "113788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.