Active NPI
St. Louis Arc Inc
- Speech-Language Pathologist
- St. Louis, MO
National Provider Identifier
1215076898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 507387603
- Legal business name
- ST. LOUIS ARC INC
- Practice address
- 1177 N. Warson Rd.
St. Louis, MO 63132 - Phone
- (314) 569-2211
- Fax
- (314) 569-3656
- NPI assigned
- Feb 6, 2007
- Organization subpart
- Yes
- Parent organization
- ST. LOUIS ARC INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathleen Tisone
- Title
- VP Operations
- Phone
- (314) 569-2211
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 507387603 | MO | |
| Pediatric Occupational Therapist | 225XP0200X | 507387603 | MO | |
| Speech-Language Pathologist | 235Z00000X | 507387603 | MO | Primary |
Addresses
Primary practice location
1177 N. Warson Rd.
St. Louis, MO 63132
Mailing address
1177 N. Warson Rd.
St. Louis, MO 63132
Phone (314) 569-2211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 507387603 | Medicaid | MO |
Other names 1
- St Louis Arc
National Provider Directory
National Provider Directory- Tax ID family
- St Louis Arc
- Part of
- St Louis Arc
Other organizations with this tax ID 25
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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- NPI 1194846220
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
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- Saint Louis, MO
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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Locations
1177 N Warson Rd
Saint Louis, MO 63132
Phone (314) 569-2211
Practitioners & affiliated clinicians
Practitioners 45
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Speech-Language Pathologist
- Saint Louis, MO
- NPI 1255446803
-
- Occupational Therapist
- Saint Louis, MO
- NPI 1750769915
-
- Behavior Analyst
- Saint Louis, MO
- NPI 1780055954
-
- Speech-Language Pathologist
- St. Louis, MO
- NPI 1306331434
-
- Speech-Language Pathologist
- St. Louis, MO
- NPI 1821428202
-
- Behavior Analyst
- Saint Louis, MO
- NPI 1699119875
-
- Speech-Language Pathologist
- Saint Louis, MO
- NPI 1770921561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1342137600000",
"number": "1215076898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 N. WARSON RD.",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63132",
"telephone_number": "314-569-2211",
"fax_number": "314-569-3656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1177 N. WARSON RD.",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63132",
"telephone_number": "314-569-2211",
"fax_number": "314-569-3656"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. LOUIS ARC INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST. LOUIS ARC INC.",
"enumeration_date": "2007-02-06",
"last_updated": "2012-07-13",
"status": "A",
"authorized_official_last_name": "TISONE",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_title_or_position": "VP OPERATIONS",
"authorized_official_telephone_number": "314-569-2211"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": "MO",
"license": "507387603",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "MO",
"license": "507387603",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "507387603",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "507387603",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St Louis Arc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in St. Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.