Prorehab, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROREHAB, PC

Practice address

2200 Barrett Station Rd Ste 200
Ballwin, MO 63021-5893

Phone

(314) 238-1130

Fax

(314) 238-1132

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Juana Granados

Title

Credentialing Manager

Phone

(630) 575-1980

Specialties & licenses 3

Addresses

Member of 1

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

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1427264233

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1376596718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BARRETT STATION RD STE 200",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215893",
            "telephone_number": "314-238-1130",
            "fax_number": "314-238-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-575-1980"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Healthcare STL LLC
• Daniel Thomas Price, RPH
• Kelly Price, PT, DPT, ATC
• Primary Care Chiropractic LLC
• Brandon Prior, DMD
• Tracy L Pulley, ATC
• Michael Vincent Purcell, DDS
• Mary Beth Puri, P.L.P.C.
• Angela Pytleski
• Quality Chiropractic Healthcare LLC

• Physical Therapy Clinic/Center in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.