Active NPI
John M Typaldos, RPT
- Physical Therapist
- Nixa, MO
National Provider Identifier
1609866110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00849
- Practice address
- 1887 N State Highway CC
Nixa, MO 65714-8015 - Phone
- (417) 725-5774
- Fax
- (417) 725-5915
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- 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 | 00849 | MO | Primary |
Addresses
Primary practice location
1887 N State Highway CC
Nixa, MO 65714-8015
Mailing address
1887 N State Highway CC
Nixa, MO 65714-8015
Phone (417) 725-5774
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 576215701 | Medicaid | MO | |
| 732515001 | Medicaid | MO |
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 |
|---|---|---|---|
| 00849 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John M. Typaldos, P.T. | Physical Therapist | Past | Accepting new patients |
| Typaldos Physical Therapy and Rehabilitation Center Inc | Past | Accepting new patients | |
| Kuehnel Rehabilitation Services LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Therapist
- Nixa, MO
- NPI 1285762914
-
- Physical Therapy Clinic/Center
- Nixa, MO
- NPI 1336139989
-
- Physical Therapy Clinic/Center
- Nixa, MO
- NPI 1366088072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1609866110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1887 N STATE HIGHWAY CC",
"city": "NIXA",
"state": "MO",
"postal_code": "657148015",
"telephone_number": "417-725-5774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1887 N STATE HIGHWAY CC",
"city": "NIXA",
"state": "MO",
"postal_code": "657148015",
"telephone_number": "417-725-5774",
"fax_number": "417-725-5915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYPALDOS",
"first_name": "JOHN",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "00849",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "576215701",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "732515001",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.