Active NPI
Patrick Daniel Fagan, D.P.T.
- Physical Therapist
- Saint Charles, MO
National Provider Identifier
1316370224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2012037663
- Practice address
- 1551 Wall St
Suite 110
Saint Charles, MO 63303-3539 - Phone
- (636) 669-2345
- Fax
- (636) 669-2344
- NPI assigned
- Aug 14, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2012037663 | MO | Primary |
Addresses
Primary practice location
1551 Wall St
Suite 110
Saint Charles, MO 63303-3539
Mailing address
1551 Wall St
Suite 110
Saint Charles, MO 63303-3539
Phone (636) 669-2345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012037663 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376438400000",
"number": "1316370224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1551 WALL ST",
"address_2": "SUITE 110",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633033539",
"telephone_number": "636-669-2345",
"fax_number": "636-669-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1551 WALL ST",
"address_2": "SUITE 110",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633033539",
"telephone_number": "636-669-2345",
"fax_number": "636-669-2344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "PATRICK",
"middle_name": "DANIEL",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-14",
"last_updated": "2013-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2012037663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
- Eye Specialists of Saint Charles, LLC
- Ezell Chiropractic LLC
- Glenn R. Ezell, D.C.
- Jeffrey Allen Fabbiano, P.L.P.C
- Facts of Life in Home Service, Inc.
- Faith Hope & Love Homecare 2 LLC
- Faith, Hope & Love Homecare, LLC
- Jason M Falcone, CRNA
- Family 1St Home Health Care LLC
- Family Advocacy and Community Training
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.