Individual provider Active NPI

Madisyn Burbridge, DPT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1528796398
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022030862 Issued in MO
Practice address
12626 Lamplighter Square Shopping Center
St. Louis, MO 63128-2746
Phone
(314) 842-4222
NPI assigned
Aug 10, 2022
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 2022030862 MO Primary

Addresses

Primary practice location

12626 Lamplighter Square Shopping Center
St. Louis, MO 63128-2746

Mailing address

12625 Slater St
Overland Park, KS 66213-4722
Phone (913) 633-8914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241105001744 MO Practitioner - Physical Therapist in Private Practice 5991239501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 1St Capitol Dr
Apt 1
Saint Charles, MO 63301-1660
Phone (636) 242-1764

9101 N Ambassador Dr
Kansas City, MO 64154-7295
Phone (816) 631-0847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022030862MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Oct 27, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Oct 27, 2024 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince Oct 27, 2024 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince Oct 27, 2024 Accepting new patients
Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 14, 2022 Accepting new patients
Elite Physical Therapy of Creve Coeur LLC Physical Therapist PastSince Aug 14, 2022 Accepting new patients

Locations

16255 Chesterfield Pkwy W
Chesterfield, MO 63017
Phone (636) 812-6942

7651 Clayton Rd
Clayton, MO 63117
Phone (314) 390-9399

12626 Lamplighter Square Shpg Ctr
Saint Louis, MO 63128
Phone (314) 842-4222

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

Organizations & group practices 6

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": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1528796398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 SLATER ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662134722",
            "telephone_number": "913-633-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12626 LAMPLIGHTER SQUARE SHOPPING CENTER",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631282746",
            "telephone_number": "314-842-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBRIDGE",
        "first_name": "MADISYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022030862",
            "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 Aug 10, 2022; 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.