Individual provider Active NPI

Carolyn Gormley, DPT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1609245596
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2012027638 Issued in MO
Practice address
7601 Watson Rd
Saint Louis, MO 63119-5001
Phone
(314) 961-8000
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2012027638 MO Primary
Physical Therapist 225100000X 15739 NC

Addresses

Primary practice location

7601 Watson Rd
Saint Louis, MO 63119-5001

Mailing address

5441 Childress Ave
Saint Louis, MO 63109-3404

Other practice location 1

1705 Tarboro St SW
Wilson, NC 27893-3428
Phone (847) 340-5687

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

LicenseStateTypeSpecialty
2012027638MOMDPhysical Therapist
15739NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St Louis LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1609245596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 CHILDRESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195001",
            "telephone_number": "314-961-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 Tarboro St SW",
            "address_purpose": "LOCATION",
            "city": "Wilson",
            "state": "NC",
            "postal_code": "278933428",
            "country_code": "US",
            "telephone_number": "847-340-5687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "CAROLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012027638",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "15739",
            "primary": false
        }
    ],
    "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 13, 2025; 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.