Active NPI
Jill Lange, DPT
- Physical Therapist
- Washington, MO
National Provider Identifier
1346677333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2013028655
- Practice address
- 201 Grand Ave
Washington, MO 63090-1209 - Phone
- (636) 239-9190
- NPI assigned
- Oct 4, 2013
- Sex
- Female
- 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 | 2013028655 | MO | Primary |
Addresses
Primary practice location
201 Grand Ave
Washington, MO 63090-1209
Mailing address
836 Ravensridge Rd
A1
Saint Louis, MO 63119-5531
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 |
|---|---|---|---|
| 2013028655 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1346677333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 RAVENSRIDGE RD",
"address_2": "A1",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631195531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 GRAND AVE",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630901209",
"telephone_number": "636-239-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "JILL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-04",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2013028655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.