Specialized Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPECIALIZED PHYSICAL THERAPY LLC

Practice address

2840 Clark Ave
Saint Louis, MO 63103-2506

Phone

(314) 970-2466

Fax

(314) 949-2523

NPI assigned

Oct 26, 2023

Last updated

Aug 12, 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

Polly Sinha, PTNPI 1730215054

Title

Owner

Phone

(404) 580-8511

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Polly Bhattacharyya Sinha, P.T.

  • Physical Therapist
  • Shiloh, IL
  • NPI 1730215054

  MO

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1386416048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 CLARK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032506",
            "telephone_number": "314-970-2466",
            "fax_number": "314-949-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 CLARK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032506",
            "telephone_number": "314-970-2466",
            "fax_number": "314-949-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "SINHA",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-580-8511",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Saint Louis, MO
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.