NPIMap

Organization Active NPI

Sports Enhancement Group LLC

  • Physical Therapist
  • Chesterfield, MO
National Provider Identifier
1720132269
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS ENHANCEMENT GROUP LLC
Practice address
217 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257
Phone
(636) 728-0889
Fax
(636) 728-1553
NPI assigned
Jan 22, 2007
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Stephen DouglasNPI 1417976044
Title
Director Owner
Phone
(636) 728-0889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

217 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257

Mailing address

217 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257
Phone (636) 728-0889

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1720132269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 CHESTERFIELD TOWNE CTR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051257",
            "telephone_number": "636-728-0889",
            "fax_number": "636-728-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 CHESTERFIELD TOWNE CTR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051257",
            "telephone_number": "636-728-0889",
            "fax_number": "636-728-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS ENHANCEMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "DIRECTOR OWNER",
        "authorized_official_telephone_number": "636-728-0889"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.