Empowerme Rehabilitation Missouri LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

EMPOWERME REHABILITATION MISSOURI LLC

Practice address

200 Maple Valley Dr
Farmington, MO 63640-1998

Phone

(844) 502-7996

NPI assigned

Sep 19, 2021

Last updated

Sep 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John David Church

Title

Vice President of Finance

Phone

(618) 972-5228

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376213520. Details of each certification follow.

• CCN 266697 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 266697

Legal name

EMPOWERME REHABILITATION MISSOURI, LLC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Feb 28, 2022

Last certification

Feb 28, 2022

Ownership / control type

Proprietary

Facility address

200 Maple Valley Drive
Farmington, MO 63640

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Pittsburgh, PA
  • NPI 1962129908

  Member Of

  NPD member

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1376213520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736005",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736005",
            "telephone_number": "844-502-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAPLE VALLEY DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401998",
            "telephone_number": "844-502-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERME REHABILITATION MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-19",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JOHN DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "618-972-5228"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Boulevard",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles Justus Elkington, DMD
• Kehaunani Elliott
• Blaine G Elsenraat, MPT
• Beth A Elser
• Shaylyn Renee Emanuel, FNP
• Abby Marie Engelbach, OTR/L
• Geraldine English, MSW, LCSW
• Kathren S Epps
• Brittany Ernst-McVeigh, DPT
• Airika Etheridge

• Rehabilitation Clinic/Center in Farmington, MO
• Providers in Farmington, MO by specialty
• Rehabilitation Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.