Active NPI
Theresa Speake, PT
- Physical Therapist
- West Plains, MO
National Provider Identifier
1376684381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02121
- Practice address
- 1100 N Kentucky Ave
West Plains, MO 65775-2029 - Phone
- (417) 257-5595
- NPI assigned
- Feb 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 02121 | MO | Primary |
Addresses
Primary practice location
1100 N Kentucky Ave
West Plains, MO 65775-2029
Mailing address
PO Box 1100
West Plains, MO 65775-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 488246919 | Medicaid | MO |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1376684381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1100",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657751100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N KENTUCKY AVE",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752029",
"telephone_number": "417-257-5595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAKE",
"first_name": "THERESA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "02121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "488246919",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Plains, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.