Orthopaedic & Sports Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT118376 Issued in MO

Legal business name

ORTHOPAEDIC & SPORTS PHYSICAL THERAPY, INC.

Doing business as

Telegraph Road Physical Therapy

Practice address

2716 Telegraph Rd
Suite #107
Saint Louis, MO 63125-4078

Phone

(314) 894-9008

Fax

(314) 894-1232

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Earl Braden Brasfield, M.S.P.T., O.C.S.NPI 1750562138

Title

Director, President, and Ceo

Phone

(314) 894-9008

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Telegraph Road Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 4

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

• Earl Braden Brasfield, M.S.P.T., O.C.S.

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1750562138
  Medicare reassignment NPD Authorized official
• Susan J Budd, PT

  • Physical Therapist
  • Fenton, MO
  • NPI 1801106109
  NPD (past)
• Richard M Kidwell, PT

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1669668828
  NPD (past)
• Wendy Marlene Malawy, MSPT

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1558166652
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649313594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 TELEGRAPH RD",
            "address_2": "SUITE #107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254078",
            "telephone_number": "314-894-9008",
            "fax_number": "314-894-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 TELEGRAPH RD",
            "address_2": "SUITE #107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254078",
            "telephone_number": "314-894-9008",
            "fax_number": "314-894-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC & SPORTS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRASFIELD",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "BRADEN",
        "authorized_official_title_or_position": "DIRECTOR, PRESIDENT, AND CEO",
        "authorized_official_telephone_number": "314-894-9008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S.P.T., O.C.S."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "PT118376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PROVIDER",
            "identifier": "2249965",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC - BS CLINIC NUMBER",
            "identifier": "31288",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "29153",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telegraph Road Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapy Clinic/Center in Saint Louis, MO
• Providers in 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 Aug 22, 2020; 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.