Active NPI
Edward Pilgrim
- Physical Therapist
- Lees Summit, MO
National Provider Identifier
1669032249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2019020713
- Practice address
- 1254 SE Century Dr
Lees Summit, MO 64081-3286 - Phone
- (816) 524-1442
- NPI assigned
- Jun 17, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2019020713 | MO | Primary |
Addresses
Primary practice location
1254 SE Century Dr
Lees Summit, MO 64081-3286
Mailing address
1254 SE Century Dr
Lees Summit, MO 64081-3286
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| STL Physical Therapy | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Saint Louis, MO
- NPI 1427918531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1669032249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1254 SE CENTURY DR",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640813286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 SE CENTURY DR",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640813286",
"telephone_number": "816-524-1442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILGRIM",
"first_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-17",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2019020713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lees Summit, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.