Individual provider Active NPI

Megan Dru Woolverton, DPT

  • Physical Therapist
  • Lake St Louis, MO
National Provider Identifier
1477336436
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2023032936 Issued in MO
Practice address
2 Harbor Bend CT Ste 102
Lake St Louis, MO 63367-1480
Phone
(636) 695-2075
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2023032936 MO Primary

Addresses

Primary practice location

2 Harbor Bend CT Ste 102
Lake St Louis, MO 63367-1480

Mailing address

201 Sorrento LN
Wentzville, MO 63385-8133
Phone (618) 638-2254

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

LicenseStateTypeSpecialty
2023032936MOMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1477336436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SORRENTO LN",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633858133",
            "telephone_number": "618-638-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HARBOR BEND CT STE 102",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671480",
            "telephone_number": "636-695-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLVERTON",
        "first_name": "MEGAN",
        "middle_name": "DRU",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2023032936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.