Active NPI
Elizabeth E Maconachy, PT DPT
- Physical Therapist
- Saint Louis, MO
National Provider Identifier
1528448644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2015027123
- Practice address
- 4444 Forest Park Ave
Ste 1210
Saint Louis, MO 63108-2212 - Phone
- (314) 286-1940
- Fax
- (314) 286-1473
- NPI assigned
- Jun 3, 2015
- 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 | 2015027123 | MO | Primary |
Addresses
Primary practice location
4444 Forest Park Ave
Ste 1210
Saint Louis, MO 63108-2212
Mailing address
4444 Forest Park Ave
C B 8502
Saint Louis, MO 63108-2212
Phone (314) 286-1940
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015027123 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479168000000",
"number": "1528448644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4444 FOREST PARK AVE",
"address_2": "C B 8502",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082212",
"telephone_number": "314-286-1940",
"fax_number": "314-286-1473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 FOREST PARK AVE",
"address_2": "STE 1210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082212",
"telephone_number": "314-286-1940",
"fax_number": "314-286-1473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACONACHY",
"first_name": "ELIZABETH",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "PT DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-03",
"last_updated": "2016-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2015027123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.