Individual provider Active NPI

Roland Scott Van Nest, P.T.

  • Physical Therapist
  • Webster Groves, MO
National Provider Identifier
1245328343
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01607 Issued in MO
Practice address
20 Allen Ave
Suite 300
Webster Groves, MO 63119-2344
Phone
(314) 961-3787
Fax
(314) 961-0974
NPI assigned
Oct 11, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 01607 MO Primary

Addresses

Primary practice location

20 Allen Ave
Suite 300
Webster Groves, MO 63119-2344

Mailing address

20 Allen Ave
Suite 300
Webster Groves, MO 63119-2344
Phone (314) 961-3787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000051 MO Practitioner - Physical Therapist in Private Practice 0547267718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Medicine and Training CenterGroup PAC ID 6305854761, 3 clinicians

Practice addresses (Care Compare)

119 Watson Plaza
St. Louis, MO 63126-1962

119 Watson PLZ
Saint Louis, MO 63126-1962
Phone (314) 961-3787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01607MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine and Training Center Physical Therapist CurrentSince Aug 15, 2002 Accepting new patients

Locations

119 Watson Plz
Saint Louis, MO 63126
Phone (314) 961-3787

20 Allen Ave
Ste 300
Webster Groves, MO 63119
Phone (314) 961-3787

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245328343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ALLEN AVE",
            "address_2": "SUITE 300",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631192344",
            "telephone_number": "314-961-3787",
            "fax_number": "314-961-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ALLEN AVE",
            "address_2": "SUITE 300",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631192344",
            "telephone_number": "314-961-3787",
            "fax_number": "314-961-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NEST",
        "first_name": "ROLAND",
        "middle_name": "SCOTT",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster Groves, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.