NPIMap

Organization Active NPI

Core Rehab and Wellness, LLC

  • Physical Therapist
  • Weldon Spring, MO
National Provider Identifier
1144867086
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CORE REHAB AND WELLNESS, LLC
Practice address
78 Gillette Field Close
Weldon Spring, MO 63304-0527
Phone
(314) 517-7669
NPI assigned
Dec 10, 2019
Last updated
Dec 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Authorized official

Name
Marjorie Rose Bennett, PT, DPTNPI 1912250994
Title
Physica Therapist, Owner
Phone
(314) 517-7669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

78 Gillette Field Close
Weldon Spring, MO 63304-0527

Mailing address

78 Gillette Field Close
Weldon Spring, MO 63304-0527
Phone (314) 517-7669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200207000462 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2961838198 Receives reassigned benefits from 11 practitioners
Practice locations: Eureka, MO; Saint Louis, MO; Weldon Spring, MO

National Provider Directory

National Provider Directory

Locations

845 N New Ballas Ct
Ste 310
Saint Louis, MO 63141
Phone (314) 692-0221

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1144867086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 GILLETTE FIELD CLOSE",
            "city": "WELDON SPRING",
            "state": "MO",
            "postal_code": "633040527",
            "telephone_number": "314-517-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 GILLETTE FIELD CLOSE",
            "city": "WELDON SPRING",
            "state": "MO",
            "postal_code": "633040527",
            "telephone_number": "314-517-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE REHAB AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PHYSICA THERAPIST, OWNER",
        "authorized_official_telephone_number": "314-517-7669",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weldon Spring, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.