Taylor M Dittmann, PT, DPT
Individual provider Active NPI Physical Therapist · Oakville, MO
NPI 1215475223 · NPPES record last updated Sep 18, 2019
Key facts
- NPI
- 1215475223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2017003393 (MO)
- Practice address
- 4418 Telegraph Rd
Oakville, MO 63129-3316 - Phone
- (314) 894-2222
- NPI assigned
- Feb 9, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190927001677 | MO | Practitioner - Physical Therapist in Private Practice | 8729318126 | Reassigns benefits to 2 organizations |
| I20191205001284 | IL | Practitioner - Physical Therapist in Private Practice | 8729318126 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FLS Physical Therapy Associates PC | Physical Therapist | Current |
Accepting new patients |
| Empowerme Wellness Kansas City, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1021 W E St
Belleville, IL 62220
Phone (618) 233-2095
357 Marketplace Dr
Freeburg, IL 62243
Phone (618) 539-2020
16255 Chesterfield Pkwy W
Chesterfield, MO 63017
Phone (636) 812-6942
2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966
1800 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 255-8094
4418 Telegraph Rd
Saint Louis, MO 63129
Phone (314) 894-2222
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2017003393 | MO | Yes |
Addresses
Primary practice location
4418 Telegraph Rd
Oakville, MO 63129-3316
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (314) 894-2222
Other practice location 1
801 Brim St
Desloge, MO 63601-3441
Phone (573) 431-0223 ext. 118
Other names
- Taylor M Chambless
Other providers in Oakville, MO
- Kevin Daniel Brennan
- Kristin Brewer
- Taylor Shae Cobbel
- Lydia Jean Ham
- Alexis Hudspeth
- Mercy Pharmacy Services LLC
- SSM Select Rehab St. Louis, LLC
- Justin Daniel Wampler
All providers in Oakville, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.