Autumn S Payne, PTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2024044437 Issued in MO

Practice address

1405 North Mount Auburn Rd
Cape Girardeau, MO 63701-2171

Phone

(573) 335-7868

Fax

(573) 335-8193

NPI assigned

Nov 26, 2024

Last updated

Nov 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Physical Therapy & Rehab, LLC.

  • Physical Therapist
  • Cape Girardeau, MO
  • NPI 1689605867
  NPD

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1376369132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 NORTH MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-335-7868",
            "fax_number": "573-335-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 NORTH MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-335-7868",
            "fax_number": "573-335-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "AUTUMN",
        "middle_name": "S",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2024044437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathleen Patterson, LPC
• Morgan Makayla Patterson
• Jeffrey Dean Patton, D.D.S.
• Paige Paullus, PHARMD
• Cliff E Pawley, ATC
• PC Medical Centers LLC
• Sonya Marie Pearman
• Emma Katherine Pearson, OD
• Kathryn Pearson
• Rachel Lin Peck, AGACNP-BC

• Physical Therapist in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.