Active NPI
Scott Gutshall, P.T.
- Physical Therapist
- St. Peters, MO
National Provider Identifier
1659519015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2004028835
- Practice address
- 34 Hillside Manor CT
St. Peters, MO 63376-4144 - Phone
- (314) 922-6844
- Fax
- (636) 294-9500
- NPI assigned
- Jan 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2004028835 | MO | Primary |
| Physical Therapist | 225100000X | 070.012079 | IL |
Addresses
Primary practice location
34 Hillside Manor CT
St. Peters, MO 63376-4144
Mailing address
34 Hillside Manor CT
St. Peters, MO 63376-4144
Phone (314) 922-6844
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070.012079 | IL | MD | Physical Therapist |
| 2004028835 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1659519015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 HILLSIDE MANOR CT",
"city": "ST. PETERS",
"state": "MO",
"postal_code": "633764144",
"telephone_number": "314-922-6844",
"fax_number": "636-294-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 HILLSIDE MANOR CT",
"city": "ST. PETERS",
"state": "MO",
"postal_code": "633764144",
"telephone_number": "314-922-6844",
"fax_number": "636-294-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTSHALL",
"first_name": "SCOTT",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-23",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2004028835",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.012079",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.