Active NPI
Tabitha Louise Scheffler, MPT
- Physical Therapist
- Fredericktown, MO
National Provider Identifier
1174650774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2004035093
- Practice address
- 803 E Hwy 72
Fredericktown, MO 63645-9620 - Phone
- (573) 783-8001
- Fax
- (573) 783-7045
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- 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 | 2004035093 | MO | Primary |
Addresses
Primary practice location
803 E Hwy 72
Fredericktown, MO 63645-9620
Mailing address
803 E Hwy 72
Fredericktown, MO 63645-9620
Phone (573) 783-8001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 487464802 | Medicaid | MO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2004035093 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235001600000",
"number": "1174650774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 E HWY 72",
"city": "FREDERICKTOWN",
"state": "MO",
"postal_code": "636459620",
"telephone_number": "573-783-8001",
"fax_number": "573-783-7045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 E HWY 72",
"city": "FREDERICKTOWN",
"state": "MO",
"postal_code": "636459620",
"telephone_number": "573-783-8001",
"fax_number": "573-783-7045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHEFFLER",
"first_name": "TABITHA",
"middle_name": "LOUISE",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2009-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2004035093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "487464802",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fredericktown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.