Active NPI
Deborah Lavender, P.T.
- Physical Therapist
- Des Peres, MO
National Provider Identifier
1467451369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- R0391
- Practice address
- 1133 Colonnade Ctr
Des Peres, MO 63131-4328 - Phone
- (314) 821-6006
- Fax
- (314) 821-6005
- NPI assigned
- Jul 21, 2005
- 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 | R0391 | MO | Primary |
Addresses
Primary practice location
1133 Colonnade Ctr
Des Peres, MO 63131-4328
Mailing address
1133 Colonnade Ctr
Des Peres, MO 63131-4328
Phone (314) 821-6006
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2243013 | Other | MO | FIRST HEALTH |
| 9195935 | Other | MO | PHCS |
| 7635608 | Other | MO | AETNA |
| 690261 | Other | MO | HEALTHLINK |
| 194278 | Other | MO | BLUE CROSS/BLUE SHIELD |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prorehab PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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
- Oak Brook, IL
- NPI 1538119409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1467451369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1133 COLONNADE CTR",
"city": "DES PERES",
"state": "MO",
"postal_code": "631314328",
"telephone_number": "314-821-6006",
"fax_number": "314-821-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 COLONNADE CTR",
"city": "DES PERES",
"state": "MO",
"postal_code": "631314328",
"telephone_number": "314-821-6006",
"fax_number": "314-821-6005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVENDER",
"first_name": "DEBORAH",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-21",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "R0391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2243013",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9195935",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7635608",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "690261",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "194278",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Peres, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.