Active NPI
Amy L Pegors, P.T.
- Physical Therapist
- Ellisville, MO
National Provider Identifier
1437106903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2009010249
- Practice address
- 16219 Autumn View Terrace Dr
Ellisville, MO 63011-4743 - Phone
- (636) 458-5225
- NPI assigned
- May 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2009010249 | MO | Primary |
Addresses
Primary practice location
16219 Autumn View Terrace Dr
Ellisville, MO 63011-4743
Mailing address
5105 Hayston CT
Saint Peters, MO 63304-7576
Phone (636) 244-1469
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009010249 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257379200000",
"number": "1437106903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 HAYSTON CT",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633047576",
"telephone_number": "636-244-1469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16219 AUTUMN VIEW TERRACE DR",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630114743",
"telephone_number": "636-458-5225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEGORS",
"first_name": "AMY",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-28",
"last_updated": "2009-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2009010249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.