Individual provider Active NPI

Joshua Patterson, DPT

  • Physical Therapist
  • Saint Peters, MO
National Provider Identifier
1710612031
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022028393 Issued in MO
Practice address
7483 Mexico Rd
Saint Peters, MO 63376-1304
Phone
(636) 206-3654
NPI assigned
Jul 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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 2022028393 MO Primary

Addresses

Primary practice location

7483 Mexico Rd
Saint Peters, MO 63376-1304

Mailing address

4273 Keaton Crossing Blvd
O Fallon, MO 63368-8220
Phone (636) 206-6540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726001954 MO Practitioner - Physical Therapist in Private Practice 1759763543 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022028393MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Jul 20, 2022 Accepting new patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Jul 20, 2022 Accepting new patients

Locations

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

1348 Bass Pro Dr
Saint Charles, MO 63301
Phone (636) 757-5075

5200 Executive Centre Pkwy
Ste 200
Saint Peters, MO 63376
Phone (636) 255-8750

7483 Mexico Rd
Saint Peters, MO 63376
Phone (636) 206-3654

21 Silo Dr
Union, MO 63084
Phone (636) 649-4131

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

Organizations & group practices 3

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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1710612031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 KEATON CROSSING BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688220",
            "telephone_number": "636-206-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7483 MEXICO RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761304",
            "telephone_number": "636-206-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JOSHUA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022028393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.