Individual provider Active NPI

Mary Felling

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1366644155
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01146 Issued in MO
Practice address
10820 Sunset Office Dr Ste 110
Saint Louis, MO 63127
Phone
(314) 965-4404
Fax
(314) 965-4464
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 01146 MO Primary

Addresses

Primary practice location

10820 Sunset Office Dr Ste 110
Saint Louis, MO 63127

Mailing address

10820 Sunset Office Dr Ste 110
Saint Louis, MO 63127-1029
Phone (314) 965-4404

Other practice location 1

142 W Madison Ave
Saint Louis, MO 63122-4213
Phone (314) 965-4404

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
01146MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1366644155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10820 SUNSET OFFICE DR STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271029",
            "telephone_number": "314-965-4404",
            "fax_number": "314-965-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 SUNSET OFFICE DR STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-965-4404",
            "fax_number": "314-965-4464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 W Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631224213",
            "country_code": "US",
            "telephone_number": "314-965-4404",
            "fax_number": "314-965-4464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELLING",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.