Robert Shawn Tucker, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

113988 Issued in MO

Practice address

2558 S Brentwood Blvd
#1 Brentwood Physical Therapy
St. Louis, MO 63144

Phone

(314) 961-8940

Fax

(314) 961-8969

NPI assigned

Sep 29, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Brentwood Physical Therapy Limited

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
  • NPI 1336122266
  NPD (past) Authorized official

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1497905327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 S BRENTWOOD BLVD",
            "address_2": "#1 BRENTWOOD PHYSICAL THERAPY",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63144",
            "telephone_number": "314-961-8940",
            "fax_number": "314-961-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 S BRENTWOOD BLVD",
            "address_2": "#1 BRENTWOOD PHYSICAL THERAPY",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63144",
            "telephone_number": "314-961-8940",
            "fax_number": "314-961-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ROBERT",
        "middle_name": "SHAWN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "113988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7477014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "231348",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Tucker
• Marissa Elaine Tucker, CRNA
• Nichole Tucker
• Robert E Tucker, MD
• Robert Nicholas Tucker
• Ryan Tucker, R.PH.
• Shannon L Tucker, AGPCNP
• Susan M Tucker, OT
• Tuckey and Associates Physical Therapy Services Inc.
• Michael Tuckey, PT

• Physical Therapist in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.

Verify at the official NPI Registry.