Individual provider Active NPI

Kasandra Bowles St. Clair, D.P.T.

  • Physical Therapist
  • Blacksburg, VA
National Provider Identifier
1407822471
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204384 Issued in VA
Practice address
1901 S Main St
Suite 8
Blacksburg, VA 24060-6600
Phone
(540) 552-3422
Fax
(540) 552-2296
NPI assigned
Feb 28, 2006
Last updated
Apr 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305204384 VA Primary

Addresses

Primary practice location

1901 S Main St
Suite 8
Blacksburg, VA 24060-6600

Mailing address

1901 S Main St
Suite 8
Blacksburg, VA 24060-6600
Phone (540) 552-3422

Other identifiers 3

IdentifierTypeStateIssuer
P00381063OtherVAMEDICARE RAILROAD
193617OtherVTANTHEM
7961679OtherVIAETNA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cawh Rehabilitation Services, LLC. Physical Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1407822471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S MAIN ST",
            "address_2": "SUITE 8",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606600",
            "telephone_number": "540-552-3422",
            "fax_number": "540-552-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S MAIN ST",
            "address_2": "SUITE 8",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606600",
            "telephone_number": "540-552-3422",
            "fax_number": "540-552-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. CLAIR",
        "first_name": "KASANDRA",
        "middle_name": "BOWLES",
        "name_prefix": "Ms.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00381063",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "193617",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7961679",
            "state": "VI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.