Laura K Wolters, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018715 Issued in IL

Practice address

1167 Konert Valley Dr
Fenton, MO 63026-7171

Phone

(573) 291-3858

NPI assigned

Sep 20, 2011

Last updated

Dec 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Saint Louis University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

In Home Physical Therapy of St Louis County LLCGroup PAC ID 1759819063, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• In Home Physical Therapy of St Louis County LLC

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1588471445
  Medicare reassignment Care Compare group NPD
• Compass Capital LLC

  • Physical Therapy Clinic/Center
  • Chesterfield, MO
  • NPI 1104772581
  NPD (past)

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1477836195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 KONERT VALLEY DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267171",
            "telephone_number": "573-291-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 KONERT VALLEY DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267171",
            "telephone_number": "573-291-3858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6800 State Route 162",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620628500",
            "country_code": "US",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLTERS",
        "first_name": "LAURA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyse Nicole Wingbermuehle, OTR/L
• Tracy Lynn Winkelmann, FNP
• Rebekah A Witte, PT, DPT
• Richard Felix Wittock III, D.P.M.
• Carrie Wolf, PT
• Nirandon Wongsurawat, MD
• Steven Michael Workman, D.M.D.
• Wuca-Fenton Pediatrics, LLC
• Michelle L Yepez, RPH
• Joseph Theodore Young, M.D.

• Physical Therapist in Fenton, MO
• Providers in Fenton, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.