Individual provider Active NPI

Shane Recer

  • Physical Therapist
  • Belleville, IL
National Provider Identifier
1154754737
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.020077 Issued in IL
Practice address
144 Lincoln Place CT
Belleville, IL 62221-5878
Phone
(618) 233-5163
Fax
(618) 233-5164
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.020077 IL Primary

Addresses

Primary practice location

144 Lincoln Place CT
Belleville, IL 62221-5878

Mailing address

15 Apex Dr
Highland, IL 62249-1282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114001854 IL Practitioner - Physical Therapist in Private Practice 4183850498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Missouri, Columbia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians

Practice addresses (Care Compare)

1503 Lindell Blvd
Granite City, IL 62040-3837
Phone (618) 709-4125

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.020077ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Aug 18, 2013 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Aug 18, 2013 Accepting new patients

Locations

1095 Belt Line Rd
Ste 400
Collinsville, IL 62234
Phone (618) 477-8550

1503 Lindell Blvd
Granite City, IL 62040
Phone (618) 709-4125

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

Organizations & group practices 2

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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1154754737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 LINCOLN PLACE CT",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215878",
            "telephone_number": "618-233-5163",
            "fax_number": "618-233-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECER",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.

Verify at the official NPI Registry.