Nicholas Ellefson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

333 S Kirkwood Rd Ste 201
Kirkwood, MO 63122-6161

Phone

(314) 909-4848

NPI assigned

Jun 18, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Training and Rehab LLCGroup PAC ID 2961487475, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Advanced Training and Rehab LLC

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1174576045
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1336982115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14515 N OUTER 40 RD STE 110",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175746",
            "telephone_number": "314-434-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S KIRKWOOD RD STE 201",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226161",
            "telephone_number": "314-909-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEFSON",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Easter Seals Midwest
• Edward F. Tate D.D.S., P.C.
• Erica Diana Edwards, BSW
• Lisa Nicole Eilerts, LCSW, RPT, CATP, JD
• Elephant Rock Counseling, LLC
• Kylie Elliott, PHARM D.
• Emily Barks DC, LLC
• Susan Amy Englund, PH D
• Michael Erlenbush
• Breanne Alexis Eversgerd, RBT

• Physical Therapist in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.