Individual provider Active NPI

Jennifer Freiburghaus

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1205341534
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
6543 Chippewa St
Saint Louis, MO 63109-4114
Phone
(314) 781-4781
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 Primary

Addresses

Primary practice location

6543 Chippewa St
Saint Louis, MO 63109-4114

Mailing address

5462 Walsh St
Saint Louis, MO 63109-2859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106002925 MO Practitioner - Physical Therapist in Private Practice 9537693056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

7920 Clayton Rd
Saint Louis, MO 63117-1327
Phone (314) 226-9614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Legacy Healthcare Services Inc. Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients

Locations

15950 Manchester Rd
Ellisville, MO 63011
Phone (636) 220-2748

7920 Clayton Rd
Saint Louis, MO 63117
Phone (314) 226-9614

6543 Chippewa St
Saint Louis, MO 63109
Phone (314) 647-6600

110 Horizon Dr
#310
Raleigh, NC 27615

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1205341534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 WALSH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6543 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631094114",
            "telephone_number": "314-781-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIBURGHAUS",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Sep 25, 2024; 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.