Individual provider Active NPI

Samuel Munie

  • Physical Therapist
  • Florissant, MO
National Provider Identifier
1629471438
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.021006 Issued in IL
Practice address
1150 Graham Rd
Florissant, MO 63031-8077
Phone
(314) 953-6090
NPI assigned
Oct 7, 2014
Last updated
May 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 070.021006 IL Primary

Addresses

Primary practice location

1150 Graham Rd
Florissant, MO 63031-8077

Mailing address

1150 Graham Rd Ste 104
Florissant, MO 63031-8077
Phone (314) 953-6090

Other practice location 1

7 Emerald Ter
Swansea, IL 62226-2321
Phone (618) 235-0700

Other practice location 2

310 W Losey St
Scott Air Force Base, IL 62225-5250
Phone (618) 256-6280

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
070.021006ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Hospital Northeast- Northwest PastSince Jun 2, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: samuel.munnie.p2@direct.athleticoltd.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1629471438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD STE 104",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-953-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-953-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Emerald Ter",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622262321",
            "country_code": "US",
            "telephone_number": "618-235-0700",
            "fax_number": "618-235-0717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 W Losey St",
            "address_purpose": "LOCATION",
            "city": "Scott Air Force Base",
            "state": "IL",
            "postal_code": "622255250",
            "country_code": "US",
            "telephone_number": "618-256-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNIE",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.021006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.