Winghaven Manual Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

LC001521081 Issued in MO

Legal business name

WINGHAVEN MANUAL PHYSICAL THERAPY

Practice address

9 Wingspan CT
Lake Saint Louis, MO 63367-1834

Phone

(636) 699-9357

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Daniel J WasheckNPI 1881788321

Title

Owner, Therapist

Phone

(636) 625-0408

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

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

• Daniel J Washeck, PT

  • Physical Therapist
  • Lake Saint Louis, MO
  • NPI 1881788321
  Medicare reassignment Care Compare group Authorized official
• Cindy Sue Washeck, P.T.

  • Physical Therapist
  • O'Fallon, MO
  • NPI 1558410365
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1619416567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MEADOWS CIRCLE DR STE 320",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633674110",
            "telephone_number": "636-625-0408",
            "fax_number": "636-625-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 WINGSPAN CT",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671834",
            "telephone_number": "636-699-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGHAVEN MANUAL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "WASHECK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "636-625-0408"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "LC001521081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Owen White, PLPC
• Cameron Whitlock
• Jennifer Wiley, RN, LMT
• Kendrick J Williams, MD
• Rachel Williams
• Shera Wiscons, LPC
• Stephanie Joyce Wolterstorff, DPT
• Daniel Orion Young, MD
• Erika Zehner, PTA

• Physical Therapy Clinic/Center in Lake Saint Louis, MO
• Providers in Lake Saint Louis, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.