Elite Physical Therapy of Creve Coeur LLC
Organization Active NPI Rehabilitation Clinic/Center · Creve Coeur, MO
NPI 1679947774 · NPPES record last updated Oct 19, 2023
Key facts
- NPI
- 1679947774
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Clinic/Center 261QR0400X
- Legal business name
- ELITE PHYSICAL THERAPY OF CREVE COEUR LLC
- Practice address
- 12788 Olive Blvd
Creve Coeur, MO 63141-6211 - Phone
- (314) 628-1206
- Fax
- (314) 628-1208
- NPI assigned
- Nov 30, 2015
- Organization subpart
- No
Authorized official
- Name
- Stephen Krzyminski
- Title
- Executive Vice President
- Phone
- (419) 221-6712
Member of 2
Practitioners 105
-
Heather Suzanne Keating, P.T.
-
Daniel Adamovsky, DPM
-
Meghan Marie Arnold, D.P.M.
-
Loren Nathan Bach, M.D.
-
Megan K Bagheri, FNP
-
Mahesh R Bagwe, M.D.
-
Anthony J Berni, M.D.
-
Saqib Bhutto, M.D.
-
Andrew Perry Bliss, PA-C
-
Leah Brancheck, M.D.
-
David Edward Brown, D.O.
-
David J Brown, M.D.
-
Tyler Calkins, MD
-
Shari D Cohen, MD
-
Shangnon Fei, MD
-
Allison Claire Flammang, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191209000314 | MO | Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 7719280841 | Practice locations: Creve Coeur, MO |
National Provider Directory
Locations
12788 Olive Blvd
Creve Coeur, MO 63141
Phone (314) 628-1206
12626 Lamplighter Square Shpg Ctr
Saint Louis, MO 63128
Phone (314) 842-4222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Yes |
Addresses
Primary practice location
12788 Olive Blvd
Creve Coeur, MO 63141-6211
Mailing address
PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717
Other names
- CORA Physical Therapy - Creve Coeur
Other providers in Creve Coeur, MO
- Tamara Kay Ehlert
- Rebecca Ehrke
- Rachel G Elbl
- Christine Marie Underwood Elder
- Robert Eugene Elder
- Brooke Elliott
- James P Emanuel
- Bryan Emerson
- Daniel Patrick Emerson
- Ashley Emge
All providers in Creve Coeur, MO · Rehabilitation Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.