Individual provider Active NPI

Jean Stiles, MPT

  • Orthopedic Physical Therapist
  • Ballwin, MO
National Provider Identifier
1417518655
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
117926 Issued in MO
Practice address
15945 Clayton Rd Ste 210
Ballwin, MO 63011-2491
Phone
(314) 325-3068
Fax
(314) 325-3069
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 117926 MO Primary

Addresses

Primary practice location

15945 Clayton Rd Ste 210
Ballwin, MO 63011-2491

Mailing address

15945 Clayton Rd Ste 210
Ballwin, MO 63011-2491
Phone (314) 325-3068

Other names 1

  • Jean Forster Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
117926MOMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1417518655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD STE 210",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112491",
            "telephone_number": "314-325-3068",
            "fax_number": "314-325-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD STE 210",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112491",
            "telephone_number": "314-325-3068",
            "fax_number": "314-325-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "JEAN",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "117926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "FORSTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.