Individual provider Active NPI

Nathan Scandrett, DPT

  • Physical Therapist
  • Godfrey, IL
National Provider Identifier
1205225075
Registry record updated Jan 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
IL 070.020882 Issued in IL
Practice address
4813 Dadrian Dr
Godfrey, IL 62035-1646
Phone
(618) 467-7071
NPI assigned
Jan 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2015

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 IL 070.020882 IL Primary

Addresses

Primary practice location

4813 Dadrian Dr
Godfrey, IL 62035-1646

Mailing address

4813 Dadrian Dr
Godfrey, IL 62035-1646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220531000959 MO Practitioner - Physical Therapist in Private Practice 8224371356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

221 Spencer Rd
Suite D
Saint Peters, MO 63376-2438
Phone (636) 477-9911

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IL 070.020882ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince May 27, 2022 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 27, 2022 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

221 Spencer Rd
Ste D
Saint Peters, MO 63376
Phone (636) 447-9911

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: nathan.scandriff.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421452800000",
    "number": "1205225075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4813 DADRIAN DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620351646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 DADRIAN DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620351646",
            "telephone_number": "618-467-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANDRETT",
        "first_name": "NATHAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-17",
        "last_updated": "2015-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "IL 070.020882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Godfrey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2015; 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.