Individual provider Active NPI

Theresa Marie Cosgrove, PT

  • Physical Therapist
  • Festus, MO
National Provider Identifier
1720305329
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
R0885 Issued in CA
Practice address
1400 Highway 61
Festus, MO 63028-4100
Phone
(636) 933-1000
Fax
(636) 931-5776
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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 R0885 CA Primary

Addresses

Primary practice location

1400 Highway 61
Festus, MO 63028-4100

Mailing address

2461 Wimbledon Estates Dr
Festus, MO 63028
Phone (636) 933-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000927 SC Practitioner - Physical Therapist in Private Practice 9436514494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Doctors of Physical Therapy LLCGroup PAC ID 5193171635, 2 clinicians

Practice addresses (Care Compare)

61 Riverwalk Blvd
Suite 2F
Ridgeland, SC 29936-5071
Phone (843) 645-6978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0885CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group of South Carolina Inc Physical Therapist CurrentSince Apr 6, 2023 Accepting new patients
Carolina Doctors of Physical Therapy, LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

3736 Robert M Grissom Pkwy
Myrtle Beach, SC 29577
Phone (843) 448-9300

61 Riverwalk Blvd
Ste F
Ridgeland, SC 29936

61 Riverwalk Blvd
Ste 2F
Ridgeland, SC 29936
Phone (843) 645-6978

Organizations & group practices 2

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1720305329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2461 WIMBLEDON ESTATES DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "63028",
            "telephone_number": "636-933-1000",
            "fax_number": "636-931-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-1000",
            "fax_number": "636-931-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSGROVE",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "R0885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.