Active NPI
Melli Anja Vytlacil, PT, DPT
- Physical Therapist
- Kirkwood, MO
National Provider Identifier
1356073175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2022024262
- Practice address
- 1001 S Kirkwood Rd Ste 150
Kirkwood, MO 63122-7251 - Phone
- (314) 821-7554
- Fax
- (314) 821-0048
- NPI assigned
- Jun 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 2022024262 | MO | Primary |
Addresses
Primary practice location
1001 S Kirkwood Rd Ste 150
Kirkwood, MO 63122-7251
Mailing address
1216 Victor St
Saint Louis, MO 63104-4326
Phone (323) 317-1164
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 |
|---|---|---|---|
| 2022024262 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1356073175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 VICTOR ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631044326",
"telephone_number": "323-317-1164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 S KIRKWOOD RD STE 150",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631227251",
"telephone_number": "314-821-7554",
"fax_number": "314-821-0048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VYTLACIL",
"first_name": "MELLI",
"middle_name": "ANJA",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MO",
"license": "2022024262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, MO
- Michael Vianin, D.C.
- Viers Hearing Centers, L.L.C.
- Visionworks Inc (Visionworks)
- David Vlaich, DPT
- Alishia Brooke Vogt, LMSW
- Lisa Waeckerle, P.T.
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2694)
- Wal-Mart Stores East, LP (Vision Center 30-2694)
- Emily Claire Walentynowicz, DPT, PT
- Walgreen Co (Walgreens #04392)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.