Active NPI
Jay L Maturan, ATC, MAT, LAT
- Sports Physical Therapist
- Warrenton, MO
National Provider Identifier
1447652540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 2014021748
- Practice address
- 605 E Booneslick Rd Ste 3
Warrenton, MO 63383-2127 - Phone
- (636) 456-6350
- NPI assigned
- Sep 19, 2014
- 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 |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 2014021748 | MO | Primary |
Addresses
Primary practice location
605 E Booneslick Rd Ste 3
Warrenton, MO 63383-2127
Mailing address
714 Eunice Ave
Saint Louis, MO 63119-1917
Phone (314) 359-5019
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 |
|---|---|---|---|
| 2014021748 | MO | MD | Sports Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Babar Enterprises LLC | Sports | Past | Accepting new patients |
| Babar Enterprises LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Warrenton, MO
- NPI 1548425002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411084800000",
"number": "1447652540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 EUNICE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631191917",
"telephone_number": "314-359-5019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 E BOONESLICK RD STE 3",
"city": "WARRENTON",
"state": "MO",
"postal_code": "633832127",
"telephone_number": "636-456-6350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATURAN",
"first_name": "JAY",
"middle_name": "L",
"credential": "ATC, MAT, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-19",
"last_updated": "2014-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "MO",
"license": "2014021748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.