Individual provider Active NPI

Zachary Sommermeyer, PT, DPT, GCS

  • Geriatric Physical Therapist
  • Fenton, MO
National Provider Identifier
1669088787
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
2005004548 Issued in MO
Practice address
22 Majestic CT
Fenton, MO 63026-2769
Phone
(314) 315-3518
NPI assigned
Sep 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 2005004548 MO Primary

Addresses

Primary practice location

22 Majestic CT
Fenton, MO 63026-2769

Mailing address

22 Majestic CT
Fenton, MO 63026-2769
Phone (314) 315-3518

Other practice location 1

65 Briarwood Cir
Worcester, MA 01606-1255
Phone (774) 436-2930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250520000778 MA Practitioner - Physical Therapist in Private Practice 9133574072 Reassigns benefits to 1 organization
I20260529000137 MO Practitioner - Physical Therapist in Private Practice 9133574072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

3300 Lake Bend Dr
Valley Park, MO 63088-2524
Phone (636) 298-1280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005004548MOMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Geriatrics CurrentSince Aug 31, 2023 Accepting new patients
St. Louis Dry Needling and Physical Therapy CurrentSince Jul 22, 2025 Accepting new patients

Locations

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

65 Briarwood Cir
Worcester, MA 01606
Phone (413) 304-2747

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1669088787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MAJESTIC CT",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262769",
            "telephone_number": "314-315-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MAJESTIC CT",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262769",
            "telephone_number": "314-315-3518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Briarwood Cir",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016061255",
            "country_code": "US",
            "telephone_number": "774-436-2930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOMMERMEYER",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, GCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MO",
            "license": "2005004548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.