Individual provider Active NPI

Molly Jo Eggers, PTA

  • Physical Therapy Assistant
  • Saint Louis, MO
National Provider Identifier
1649416769
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2008020471 Issued in MO
Practice address
4850 Lemay Ferry Rd
Suite 101
Saint Louis, MO 63129-1576
Phone
(314) 416-0439
Fax
(314) 487-3062
NPI assigned
Dec 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2008020471 MO Primary

Addresses

Primary practice location

4850 Lemay Ferry Rd
Suite 101
Saint Louis, MO 63129-1576

Mailing address

4850 Lemay Ferry Rd
Suite 101
Saint Louis, MO 63129-1576
Phone (314) 416-0439

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2008020471MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1649416769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD",
            "address_2": "SUITE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291576",
            "telephone_number": "314-416-0439",
            "fax_number": "314-487-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD",
            "address_2": "SUITE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291576",
            "telephone_number": "314-416-0439",
            "fax_number": "314-487-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGERS",
        "first_name": "MOLLY",
        "middle_name": "JO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2008020471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Dec 18, 2008; 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.