Individual provider Active NPI

Sandra Lynn Schulten

  • Physical Therapy Assistant
  • Saint Louis, MO
National Provider Identifier
1710104096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
116711 Issued in MO
Practice address
11701 Borman Dr Ste 280
Saint Louis, MO 63146-4199
Phone
(314) 983-9555
NPI assigned
Apr 19, 2007
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 Therapy Assistant 225200000X 116711 MO Primary

Addresses

Primary practice location

11701 Borman Dr Ste 280
Saint Louis, MO 63146-4199

Mailing address

990 Piedras Pkwy
Fenton, MO 63026-3757

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
116711MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710104096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 PIEDRAS PKWY",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 BORMAN DR STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464199",
            "telephone_number": "314-983-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTEN",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "116711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.