Individual provider Active NPI

Anne M Joergens, PT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1205101409
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01905 Issued in MO
Practice address
11969 Westline Industrial Dr
Saint Louis, MO 63146-3203
Phone
(314) 819-0480
NPI assigned
Mar 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 01905 MO Primary
Physical Therapist 225100000X 070.009192 IL

Addresses

Primary practice location

11969 Westline Industrial Dr
Saint Louis, MO 63146-3203

Mailing address

11969 Westline Industrial Dr
Saint Louis, MO 63146-3203
Phone (314) 819-0480

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

LicenseStateTypeSpecialty
070.009192ILMDPhysical Therapist
01905MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1205101409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11969 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463203",
            "telephone_number": "314-819-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11969 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463203",
            "telephone_number": "314-819-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOERGENS",
        "first_name": "ANNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01905",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.009192",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.