Renee A Ivens, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

01496 Issued in MO

Practice address

4240 Duncan Ave
Dept Physical Therapy, Ste 120
Saint Louis, MO 63110-1101

Phone

(314) 286-1940

Fax

(314) 286-1473

NPI assigned

Jul 14, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1376569590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60352",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631600352",
            "telephone_number": "314-286-1940",
            "fax_number": "314-286-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 DUNCAN AVE",
            "address_2": "DEPT PHYSICAL THERAPY, STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101101",
            "telephone_number": "314-286-1940",
            "fax_number": "314-286-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVENS",
        "first_name": "RENEE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480057362",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4240 Duncan Ave",
            "address_2": "Dept Physical Therapy, Ste 120",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Diane Itzkowitz, M.D.
• Sven Kevin Ivankovic, MD
• Milos Ivanovic, MD
• Pranati Ivaturi, M.D.
• Shyam S Ivaturi, M.D.
• Jessica Iver, ATC, LAT
• Whittney Renae Iver, FNP
• Jennifer J Iverson, ED.S., LPC, RPT
• Kimberly Susan Iverson, MT-BC
• Virginia A Ives, LCSW, MSW,ACSW MAED,

• Physical Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.