Individual provider Active NPI

Phillip J Ward, DPT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1619318441
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2013013589 Issued in MO
Practice address
12639 Old Tesson Rd
Saint Louis, MO 63128-2711
Phone
(143) 849-0311
NPI assigned
Jul 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 2013013589 MO Primary

Addresses

Primary practice location

12639 Old Tesson Rd
Saint Louis, MO 63128-2711

Mailing address

12639 Old Tesson Rd
Saint Louis, MO 63128-2711
Phone (314) 849-0311

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Phillip.ward@direct.signature.nextgenshare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023000914 MO Practitioner - Physical Therapist in Private Practice 8820223183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians

Practice addresses (Care Compare)

12639 Old Tesson Rd
Suite 115
Saint Louis, MO 63128-2786
Phone 31484903112384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Medical Group, Inc CurrentSince Apr 25, 2022 Accepting new patients
Signature Medical Group, Inc CurrentSince Apr 25, 2022 Accepting new patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince Oct 10, 2016 Accepting new patients

Locations

1895 Richardson Rd
Arnold, MO 63010
Phone (314) 756-2800

6623 Mall Dr
Cedar Hill, MO 63016
Phone (636) 748-1999

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

425 N New Ballas Rd
Ste 202
Saint Louis, MO 63141
Phone (314) 991-2562

12639 Old Tesson Rd
Saint Louis, MO 63128
Phone (314) 446-0291

12639 Old Tesson Rd
Ste 115
Saint Louis, MO 63128
Phone (314) 842-8655

9901 Watson Rd
Ste 153
Saint Louis, MO 63126
Phone (314) 270-8671

Interoperability endpoints

  • Direct secure messaging: phillip.ward.p2@direct.athleticoltd.nextgenshare.com
  • Direct secure messaging: phillip.ward@direct.signature.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1619318441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282711",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282711",
            "telephone_number": "143-849-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "PHILLIP",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2013013589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Phillip.ward@direct.signature.nextgenshare.com",
            "affiliation": "N",
            "address_1": "12639 Old Tesson Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631282711",
            "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 Apr 21, 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.