NPIMap

Organization Active NPI

Advance Physical Therapy & Sports Medicine of Lewis County LLC

  • Physical Therapist
  • Canton, MO
National Provider Identifier
1326058322
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ADVANCE PHYSICAL THERAPY & SPORTS MEDICINE OF LEWIS COUNTY LLC
Practice address
1100 E Outer Rd S Ste 1
Canton, MO 63435-1701
Phone
(573) 288-3311
Fax
(573) 288-1223
NPI assigned
Aug 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gregory ReisNPI 1972519171
Title
Partner
Phone
(217) 222-6800

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 Therapist 225100000X Primary

Addresses

Primary practice location

1100 E Outer Rd S Ste 1
Canton, MO 63435-1701

Mailing address

1100 E Outer Rd S Ste 1
PO Box 244
Canton, MO 63435-1701
Phone (573) 288-3311

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326058322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E OUTER RD S STE 1",
            "address_2": "PO BOX 244",
            "city": "CANTON",
            "state": "MO",
            "postal_code": "634351701",
            "telephone_number": "573-288-3311",
            "fax_number": "573-288-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E OUTER RD S STE 1",
            "city": "CANTON",
            "state": "MO",
            "postal_code": "634351701",
            "telephone_number": "573-288-3311",
            "fax_number": "573-288-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PHYSICAL THERAPY & SPORTS MEDICINE OF LEWIS COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REIS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "217-222-6800"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.