Active NPI
Angela Durham, DPT
- Physical Therapist
- Fenton, MO
National Provider Identifier
1356840607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2018003408
- Practice address
- 1391 Smizer Mill Rd
Fenton, MO 63026-7306 - Phone
- (636) 305-3000
- NPI assigned
- Feb 1, 2018
- 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 | 2018003408 | MO | Primary |
Addresses
Primary practice location
1391 Smizer Mill Rd
Fenton, MO 63026-7306
Mailing address
14515 North Outer 40 Rd
Chesterfield, MO 63017-5791
Phone (314) 434-8680
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517443200000",
"number": "1356840607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14515 NORTH OUTER 40 RD",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630175791",
"telephone_number": "314-434-8680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1391 SMIZER MILL RD",
"city": "FENTON",
"state": "MO",
"postal_code": "630267306",
"telephone_number": "636-305-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "ANGELA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-01",
"last_updated": "2018-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2018003408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.