Individual provider Active NPI

Tara Busch, PT

  • Physical Therapist
  • Belleville, IL
National Provider Identifier
1700088747
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2810 Frank Scott Pkwy W
Suite 824
Belleville, IL 62223-5007
Phone
(618) 234-9705
Fax
(618) 234-9867
NPI assigned
Jun 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

2810 Frank Scott Pkwy W
Suite 824
Belleville, IL 62223-5007

Mailing address

2810 Frank Scott Pkwy W
Suite 824
Belleville, IL 62223-5007
Phone (618) 234-9705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220512001178 MO Practitioner - Physical Therapist in Private Practice 9133506116 Reassigns benefits to 2 organizations
I20220518002150 IL Practitioner - Physical Therapist in Private Practice 9133506116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1021 W E St
Belleville, IL 62220-1055
Phone (618) 573-3402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince May 9, 2022 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Empowerme Rehabilitation Missouri LLC Physical Therapist CurrentSince May 9, 2022 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767

1800 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 255-8094

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700088747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "address_2": "SUITE 824",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-9705",
            "fax_number": "618-234-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "address_2": "SUITE 824",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-9705",
            "fax_number": "618-234-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "TARA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.