NPIMap

Organization Active NPI

Boutique Physio, Inc

  • Physical Therapist
  • University City, MO
National Provider Identifier
1295387041
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BOUTIQUE PHYSIO, INC
Practice address
909 Purdue Ave
University City, MO 63130-3012
Phone
(314) 802-7337
NPI assigned
Jul 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joanne MaczaNPI 1639189921
Title
Physical Therapist/Owner
Phone
(314) 802-7337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

909 Purdue Ave
University City, MO 63130-3012

Mailing address

909 Purdue Ave
University City, MO 63130-3012
Phone (314) 802-7337

National Provider Directory

National Provider Directory

Locations

909 Purdue Ave
University City, MO 63130
Phone (314) 802-7337

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1295387041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 PURDUE AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303012",
            "telephone_number": "314-802-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 PURDUE AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303012",
            "telephone_number": "314-802-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUTIQUE PHYSIO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "MACZA",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "314-802-7337"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.