Individual provider Active NPI

Jeremy M Kertz, DPT

  • Physical Therapist
  • O Fallon, MO
National Provider Identifier
1275004798
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2019003975 Issued in MO
Practice address
343 Winding Woods Ctr
O Fallon, MO 63366-4170
Phone
(636) 439-2004
Fax
(636) 439-2054
NPI assigned
Dec 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 2019003975 MO Primary

Addresses

Primary practice location

343 Winding Woods Ctr
O Fallon, MO 63366-4170

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

4273 Keaton Crossing Blvd
O Fallon, MO 63368-8220
Phone (636) 206-6540

Other practice location 2

784 Gravois Bluffs Blvd
Fenton, MO 63026-7726
Phone (636) 349-8060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190226001310 MO Practitioner - Physical Therapist in Private Practice 5395084982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, shared by 41 NPIs, 2,187 clinicians
Axes Physical Therapy LLCGroup PAC ID 3375840028, 112 clinicians

Practice addresses (Care Compare)

343 Winding Woods Ctr
O Fallon, MO 63366-4170
Phone (636) 439-2004

4273 Keaton Crossing Blvd
O Fallon, MO 63368-8220
Phone (636) 206-6540

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
2019003975MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Axes Physical Therapy I, LLC CurrentSince Sep 30, 2024 Accepting new patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Axes Physical Therapy I, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients

Locations

14081 Manchester Rd
Ballwin, MO 63011
Phone (636) 223-5700

647 Spirit Airpark West Dr
Ste 101
Chesterfield, MO 63005
Phone (636) 223-5700

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

1201 Hrc Plaza Dr
Lake St Louis, MO 63367
Phone (636) 493-8156

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

1348 Bass Pro Dr
Saint Charles, MO 63301
Phone (636) 757-5075

21 Silo Dr
Union, MO 63084
Phone (636) 649-4131

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

Interoperability endpoints

  • Direct secure messaging: jeremy.kertz.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 4

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1275004798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 WINDING WOODS CTR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633664170",
            "telephone_number": "636-439-2004",
            "fax_number": "636-439-2054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4273 Keaton Crossing Blvd",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633688220",
            "country_code": "US",
            "telephone_number": "636-206-6540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "784 Gravois Bluffs Blvd",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630267726",
            "country_code": "US",
            "telephone_number": "636-349-8060",
            "fax_number": "636-349-9171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERTZ",
        "first_name": "JEREMY",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2019003975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.