Spine Rehab at Home LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SPINE REHAB AT HOME LLC

Practice address

481 Dana Meadows LN
Ballwin, MO 63021-6493

Phone

(314) 626-3161

NPI assigned

Jul 14, 2020

Organization subpart

No

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

Authorized official

Name

Kyle Winters, DPTNPI 1700200821

Title

Owner

Phone

(314) 626-3161

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Winters

  • Physical Therapist
  • Ballwin, MO
  • NPI 1700200821
  Medicare reassignment Care Compare group NPD Authorized official
• Casey Jane Palacios, MPT

  • Physical Therapist
  • Ballwin, MO
  • NPI 1346036555
  Medicare reassignment Care Compare group NPD
• Shecanna R Seeley, M.P.T., A.T.C.

  • Physical Therapist
  • Robinson, IL
  • NPI 1508810391

  MO

  Medicare reassignment Care Compare group NPD
• Laura Szczepan

  • Orthopedic Physical Therapist
  • Glen Carbon, IL
  • NPI 1629521802

  MO

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1396353587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 DANA MEADOWS LN",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630216493",
            "telephone_number": "314-626-3161",
            "fax_number": "314-200-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 DANA MEADOWS LN",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630216493",
            "telephone_number": "314-626-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE REHAB AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-626-3161",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Frank Sobocinski, RPH
• Gina Rivera Sokolich
• Nidhi Soni, D.C.
• Speech & Language Center STL
• Amina Spijodic, FNP-C
• St Louis Concierge PT and Wellness LLC
• St. Louis Breast Center LLC
• St. Louis Center for Neurodiversity, LLC
• St. Louis Women'S Surgery Center, LLC (St. Louis Multispecialty Surgery Center)
• Stadnyk & Drissell & Associates P.C. (Kehrs Mill Dental Arts)

• 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 May 5, 2023; 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.