Individual provider Active NPI

Maria Teresa Astadan Nakila, PT, DPT

  • Physical Therapist
  • Marion, IL
National Provider Identifier
1366186116
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-06965 Issued in KS
Practice address
906 Skyline Dr Ste 200
Marion, IL 62959-4876
Phone
(618) 997-6565
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-06965 KS Primary

Addresses

Primary practice location

906 Skyline Dr Ste 200
Marion, IL 62959-4876

Mailing address

108 N 5TH St Apt C
Marion, IL 62959-4707
Phone (618) 922-2470

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

State licenses

LicenseStateTypeSpecialty
11-06965KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC CurrentSince Sep 8, 2023 Accepting new patients
Denver Physical Therapy at Home Physical Therapist CurrentSince Sep 13, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Sep 8, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Sep 8, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Sep 8, 2023 Accepting new patients
Rodrigo D. Rodriguez PastSince Sep 13, 2024 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1366186116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N 5TH ST APT C",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594707",
            "telephone_number": "618-922-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 SKYLINE DR STE 200",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594876",
            "telephone_number": "618-997-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKILA",
        "first_name": "MARIA TERESA",
        "middle_name": "ASTADAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.

Verify at the official NPI Registry.