Active NPI
Benjamin C Robarge, PTA
- Physical Therapy Assistant
- Festus, MO
National Provider Identifier
1437926326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2021029778
- Practice address
- 1500 Midmeadow LN
Festus, MO 63028-1544 - Phone
- (636) 937-4920
- NPI assigned
- Dec 11, 2023
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 2021029778 | MO | Primary |
Addresses
Primary practice location
1500 Midmeadow LN
Festus, MO 63028-1544
Mailing address
2707 Breakwater Dr
Imperial, MO 63052-4318
Phone (919) 648-8572
Other practice location 1
400 Joachim Ave
Herculaneum, MO 63048-1011
Phone (636) 479-5200
Other practice location 2
6003 6th St
Imperial, MO 63052-2428
Phone (636) 464-4400
Other practice location 3
3775 Athena School Rd
DE Soto, MO 63020-4588
Phone (636) 586-1020
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 |
|---|---|---|---|
| 2021029778 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1437926326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 BREAKWATER DR",
"city": "IMPERIAL",
"state": "MO",
"postal_code": "630524318",
"telephone_number": "919-648-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 MIDMEADOW LN",
"city": "FESTUS",
"state": "MO",
"postal_code": "630281544",
"telephone_number": "636-937-4920"
}
],
"practiceLocations": [
{
"address_1": "400 Joachim Ave",
"address_purpose": "LOCATION",
"city": "Herculaneum",
"state": "MO",
"postal_code": "630481011",
"country_code": "US",
"telephone_number": "636-479-5200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6003 6th St",
"address_purpose": "LOCATION",
"city": "Imperial",
"state": "MO",
"postal_code": "630522428",
"country_code": "US",
"telephone_number": "636-464-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3775 Athena School Rd",
"address_purpose": "LOCATION",
"city": "DE Soto",
"state": "MO",
"postal_code": "630204588",
"country_code": "US",
"telephone_number": "636-586-1020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBARGE",
"first_name": "BENJAMIN",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-12-11",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2021029778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Festus, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.