Active NPI
Jean Stiles, MPT
- Orthopedic Physical Therapist
- Ballwin, MO
National Provider Identifier
1417518655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 117926
- 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
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 |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 117926 | MO | MD | Orthopedic 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.