NPIMap

Organization Active NPI

Superior Healthcare Physical Medicine of West County, LLC

  • Physical Medicine & Rehabilitation Physician
  • Saint Peters, MO
National Provider Identifier
1538860267
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SUPERIOR HEALTHCARE PHYSICAL MEDICINE OF WEST COUNTY, LLC
Practice address
5650 Mexico Rd Ste 2
Saint Peters, MO 63376-1696
Phone
(636) 875-1270
Fax
(636) 875-1278
NPI assigned
Mar 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Authorized official

Name
Daniel GogliottiNPI 1962848465
Title
Owner
Phone
(314) 394-1923

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

5650 Mexico Rd Ste 2
Saint Peters, MO 63376-1696

Mailing address

2121 Barrett Station Rd
Saint Louis, MO 63131-1606
Phone (314) 394-1923

National Provider Directory

National Provider Directory

Locations

5650 Mexico Rd
Ste 2
Saint Peters, MO 63376
Phone (636) 875-1270

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1538860267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 BARRETT STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311606",
            "telephone_number": "314-394-1923",
            "fax_number": "314-394-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 MEXICO RD STE 2",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761696",
            "telephone_number": "636-875-1270",
            "fax_number": "636-875-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR HEALTHCARE PHYSICAL MEDICINE OF WEST COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "GOGLIOTTI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-394-1923"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.