Individual provider Active NPI

Jarek Penney

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1528616208
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013543A Issued in IN
Practice address
10199 Woodfield LN
Saint Louis, MO 63132-2922
Phone
(877) 407-3422
NPI assigned
Aug 27, 2019
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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 05013543A IN Primary

Addresses

Primary practice location

10199 Woodfield LN
Saint Louis, MO 63132-2922

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Other practice location 1

3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766
Phone (877) 407-3422

Other practice location 2

1650 High St
Washington, MO 63090-4365
Phone (877) 407-3422

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other FOX REHABILITATION SERVICES PT MO LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other FOX REHABILITATION SERVICES PT MO LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191008003317 IN Practitioner - Physical Therapist in Private Practice 7719218577 Reassigns benefits to 1 organization
I20241125001665 MO Practitioner - Physical Therapist in Private Practice 7719218577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services PT Mo LLCGroup PAC ID 1254754948, 33 clinicians

Practice addresses (Care Compare)

1650 High St
Washington, MO 63090-4365
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05013543AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Indiana LLC Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients
Fox Rehabilitation Services PT Mo LLC Physical Therapist CurrentSince Sep 19, 2024 Accepting new patients

Locations

14901 Carey Rd
Carmel, IN 46033

3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 566-2035

10199 Woodfield Ln
Saint Louis, MO 63132
Phone (314) 485-5845

1650 High St
Washington, MO 63090
Phone (636) 390-3290

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1528616208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10199 WOODFIELD LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631322922",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3815 River Crossing Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462407766",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650 High St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630904365",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNEY",
        "first_name": "JAREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013543A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "FOX REHABILITATION SERVICES PT MO LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10199 Woodfield Ln",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631322922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "FOX REHABILITATION SERVICES PT MO LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1650 High St",
            "city": "Washington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630904365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 24, 2025; 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.