NPIMap

Organization Active NPI

Jefferson County Rehabilitation

  • Physical Therapy Clinic/Center
  • Festus, MO
National Provider Identifier
1154445369
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
00947 Issued in MO
Legal business name
JEFFERSON COUNTY REHABILITATION
Practice address
1330 YMCA Dr
Suite 1200
Festus, MO 63028-2661
Phone
(636) 931-7600
Fax
(636) 931-8808
NPI assigned
Mar 16, 2007
Last updated
Sep 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Michael Thomas Cibulka, PTNPI 1134163603
Title
Owner
Phone
(636) 931-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 00947 MO Primary

Addresses

Primary practice location

1330 YMCA Dr
Suite 1200
Festus, MO 63028-2661

Mailing address

1330 YMCA Dr
Suite 1200
Festus, MO 63028-2661
Phone (636) 931-7600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1154445369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 YMCA DR",
            "address_2": "SUITE 1200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282661",
            "telephone_number": "636-931-7600",
            "fax_number": "636-931-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 YMCA DR",
            "address_2": "SUITE 1200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282661",
            "telephone_number": "636-931-7600",
            "fax_number": "636-931-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "CIBULKA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-931-7600",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "00947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.